Parents' perspective on children's access to healthcare services and associated factors: a cross-sectional study

Poor access to health services endangers children's health and development. Parents' perspectives are essential for understanding barriers to children's healthcare access, as they often serve as primary caregivers and decision-makers. This research aimed to explore parents' perspective on children's access to healthcare services and its associated factors.

In this cross-sectional study, 317 parents of children aged ≤ 18, chosen by two-stage cluster sampling participated. Data was collected by the standard questionnaire of the European Patient Forum with some changes. It evaluates overall access to healthcare and its five main dimensions: information availability, affordability, physical accessibility, appropriateness and adequacy. Translation of the questionnaire into Persian included forward and backward translations and expert committee discussions. Cronbach's alpha was 0.935 approving questionnaire's reliability. A 5-point Likert scale was used to rate the status of access (very low = 1, very high = 5). Descriptive statistics and ordinal logistic regression were used to assess the factors associated with access. Data analysis was performed in STATA17 at a significant level of p < 0.05.

Most study participants were women (n = 189, 60%) 31-40 years old (n = 132, 42%), had a high school degree (n = 198, 60.7%), 2-3 children (n = 158, 49.8%), average income (n = 126, 39.7%) and basic health insurance (n = 222,7%). The mean score of children's overall access to health services was 2.8 ± 1.2, and for its dimensions from highest to the lowest was physical accessibility: 3.19 ± 0.87, appropriateness: 2.81 ± 1.1, information availability: 2.76 ± 0.98, adequacy: 2.60 ± 1.07 and affordability: 1.36 ± 1.07. There was a significant relationship parents' education level, income and supplementary health insurance and access to healthcare services (p < 0.05).

From parents' perspective, the access of children and it's all dimensions: information availability, affordability, physical accessibility, appropriateness and adequacy need improvement. Policymakers should ensure all children receive necessary care by providing affordable subsidized health services. Children should have access to age-friendly health information and be supported to participate in healthcare decisions. To make health services more appropriate, it is necessary to train the staff about professional ethics and equal treatment of all patients.