Factors Affecting Accessibility of Health Care Services among People with Mueang Uttaradit District, Uttaradit
Keywords:
persons with disabilities, health service access, health service awarenessAbstract
This study aimed to examine the level of access to health services among persons with disabilities in Mueang District, Uttaradit Province, and to identify factors influencing their access to care. A cross-sectional descriptive design was employed. The sample consisted of 254 persons with disabilities selected through multistage sampling. Data were collected using a researcher-developed interview questionnaire comprising personal characteristics, awareness of health services, health service utilization, social support, and satisfaction with health services. Content validity was verified by expert review, and reliability was assessed using KR-20 and Cronbach’s alpha coefficients ranging from .79 to .89. Data were analyzed using descriptive statistics, Chi-square test, and multiple logistic regression.
The results revealed that the majority of persons with disabilities had a high level of access to health services (88.8%). Those with mobility and visual impairments demonstrated higher access compared to other groups. Among personal factors, sex was significantly associated with health service access (p < .05), while age, education, income, underlying disease, and type of disability showed no significant association. Regarding awareness of available health services, three dimensions—health promotion, disease prevention, and rehabilitation—were significant predictors of access. Participants with high awareness were 17 to 46 times more likely to access services compared to those with low awareness. Social support showed no statistical association with service access. The final regression model explained 48.3% of the variance in health service access. In conclusion, awareness of health services plays a critical role in enabling access to care among persons with disabilities. Efforts should focus on strengthening communication strategies related to service information and health rights, tailoring information formats to different types of disabilities, and expanding proactive services such as home visits and community-based rehabilitation. Enhancing the capacity of primary care units may further improve equitable access and continuity of care for this vulnerable population.
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