Chung-Yi Chiu, PhD, CRC; Malachy Bishop, PhD, CRC; JJ Pionke, MA, MSI; David Strauser, PhD, CRC; Ryan L. Santens, MPH, MSW

Correspondence: Chung-Yi Chiu, PhD, CRC, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 S. Fourth St., Champaign, IL 61820; e-mail: chiucy@illinois.edu.

Background: Individuals with multiple sclerosis (MS) face a range of barriers in accessing and using health-care services. The aim of this literature review was to identify specific barriers to accessing and using health-care services based on a continuum of the health-care delivery system.

Methods: Literature searches were conducted within the following databases: PubMed, PsycInfo, CINAHL Nursing Literature, and Web of Science. The following terms were searched as subject headings, keywords, or abstracts: health care, access, barriers, physical disability, and multiple sclerosis. The literature search produced 361 potentially relevant citations. After screening titles, abstracts, and citations, eight citations were selected for full-text review.

Results: Health-care barriers were divided into three continuous phases of receiving health care, namely, before, during, and after visit phases. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern for individuals with MS. In the after-visit phase, discontinued referral was the major barrier encountered by individuals with MS.

Conclusions: There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum. These range from complex and long-recognized barriers that will likely require extended advocacy to create policy changes, to issues that can and should be addressed through relatively minor changes in health-care delivery practices, improved care coordination, and increased provider awareness, education, and responsiveness to patients’ needs.