Re-evaluating the access imperative in healthcare in the United States

Access to healthcare, defined by the Institute of Medicine as "the timely use of personal health services to achieve the best health outcome" represents one of the most critical issues facing modern societies. However, barriers to access are increasingly being recognized across all populations especially as the boundaries between technology, medicine, business, public health, and policy become blurred. Given that resource and infrastructural constraints have been well established to influence access, organizations have the responsibility to continually evaluate this concept in the context of inclusivity and social determinants of health. Ultimately, improving access requires thoughtful engagement from a myriad of stakeholders with the goal of prioritizing timely, equitable, personalized, and high-quality care, while empowering patients to take charge of their own health. While a profound challenge, the journey toward bridging the many gaps is just beginning, and how society re-defines the access imperative in healthcare in an ever-evolving landscape represents one of the foremost issues of the future. Indeed, the implications for society are tremendous given that access is central to quality of care, profoundly impacts the patient experience, and influences health outcomes. The purpose of this review is to outline the core issues that contribute to access focusing on barriers, social determinants, quality of care, and potential interventions.