Extensive Quantitative Studies of Activity Limitations and Access to Healthcare

The survey will collect data in order to gain a broader understanding of the knowledge, attitudes and practices of vulnerable groups with respect to their needs for health services, the accessibility of health services and the quality of health services provided. The survey will contribute to study these phenomena through collecting data on a range of factors expected to influence accessibility and service delivery. Data will be collected on activity limitations of household members, the household composition, household income, expenditure and transfers in cash or kind in and out of the household, educational achievement and employment status, and so on. Perceptions of health service costs, actually costs and ‘opportunity costs’ will also be measures.

Analyses of existing data from large data-bases on living conditions among people with disabilities will be carried out to inform the design of the survey in WP4. The Results of the earlier work in WP3 will also feed into the development of the survey instrument.

The household survey will be carried out in the same sites as the qualitative study in WP3. The sample size in each selected site will be determined in such a way as to provide the required number of cases to allow for both descriptive and analytical purposes. Based on prior experience in this sort of work, we estimate that a sample of 400 – 500 per site, or around 2000 per participating country, should be adequate and provide the necessary power to both test broad hypotheses and more context specific ones that may be emergent from WPS.

Analyses will include Principal Components Analysis to explore the factorial structure of the survey instrument and assess the comparability of its behaviour across different cultural contexts. Variables concerned with activity limitations; contextual and systems variables; and personal and community coping resources, will then be combined to explore how these affect access to healthcare; across a number of different types of healthcare facilities. We anticipate a variety of multivariate analyses including tests of association (such as Path Analysis and Regression Analysis) and tests of difference (such as Analysis of Variance and T-tests). We aim to produce a series of statistical models to optimally describe critical relationships between activity limitations and access to health care, their mediating and/or interacting variables.

Contact / Work Package leader: 

• SINTEF, Global Health and Welfare: