Barriers to the accessibility and continuity of health-care services in people with multiple sclerosis

Chungyi Chiu, Malachy Bishop, J. J. Pionke, David Strauser, Ryan L. Santens

Research output: Contribution to journalArticlepeer-review


Individuals with multiple sclerosis (MS) face a range of barriers to accessing and using health-care services. The aim of this review was to identify specific barriers to accessing and using healthcare services based on a continuum of the health-care delivery system. Methods: Literature searches were conducted in the PubMed, PsycINFO, CINAHL, and Web of Science databases. The following terms were searched as subject headings, key words, 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. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern. In the after-visit phase, discontinued referral was the major barrier encountered. Conclusions: There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum for people with MS and its associated physical disabilities, ranging 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.

Original languageEnglish (US)
Pages (from-to)313-322
Number of pages10
JournalInternational Journal of MS Care
Issue number6
StatePublished - Nov 1 2017

ASJC Scopus subject areas

  • Clinical Neurology
  • Advanced and Specialized Nursing


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