Systemic Primary Healthcare Access Inequities : A Cross Sectional Analysis Of Marginalised And Non-Marginalised Populations’ Experiences With Primary Healthcare Services In Sweden And The Nordic Countries

Sammanfattning: Introduction The differential accessibility of healthcare services in the Nordic region can be drawn along socioeconomic and sociodemographic lines. Previous literature has established the association between the processes of marginalisation and inequitable healthcare access outcomes. This study contributes to existing knowledge by exploring the association with regard to primary healthcare service accessibility.     Methods Logistic regression assessed the association between perceived marginalisation and medical consultation barriers. A multinomial regression further analysed the specific type of systemic primary healthcare barriers marginalised respondents were more likely to encounter in comparison to non-marginalised respondents. This analysis used data from 5,689 respondents residing in the Nordic region from the 7th round of the European Social Survey.   Results After adjusting for health problems, socioeconomic, sociodemographic, and sociocultural factors, respondents who reported perceived marginalisation were more likely to face healthcare access barriers (OR = 2.87, 95 % CI = 2.28 – 3.64, p < 0.001). Additionally, marginalised respondents were more likely to report facing systemic access barriers pertaining to long wait times in comparison to non-marginalised respondents (RRR = 3.69, 95% CI = 2.52– 5.40, p < 0.001).    Conclusion This thesis observes that individuals who see themselves as marginalised invariably encounter amplified systemic obstacles when seeking primary healthcare services. Public health policies in the Nordics aimed at increasing accessibility have not conclusively resulted in an improved accessibility among marginalised communities. Thus, a re-evaluation of policies aimed at improving primary healthcare access is necessary.