Failure to seek needed medical care: Results from a national health survey of Icelanders

The study focuses on access to outpatient medical care in Iceland--a socialized health care system. As in other systems of this sort, equal access to needed services (equity) is a fundamental principle. Despite governmental claims that access to health services is "easy" and "roughly equal", the study indicates substantial and rather extensive variations in equity of care. More specifically, younger individuals, the non-widowed, the economically troubled, individuals with inflexible daily schedules, the chronically ill, those who had incurred high out-of-pocket costs relative to their family income, and those who didn't have a physician care discount card, were more likely than others to postpone or cancel an MD visit they thought they needed. Furthermore, younger age, economic troubles, chronic medical conditions, no family physician, and no physician care discount card, were all related to under-utilization, based on medical specialist criteria of recommended medical care for symptoms. Although the results show that access problems originate in part outside the health care system, they also suggest revision of current health policy, in order to adequately address existent inequities in service delivery.