The authors of this chapter of the Anthology document the strategies used over time by Robert Wood Johnson Foundation grantees tracking access to health care among Americans. The four national surveys of access to care that are discussed, represent the Foundation's flagship investment in analysis related to problems of access. One goal of these surveys has been to gain an understanding of the extent and nature of the problem. An even more important goal has been to focus attention on the problems faced by individuals who cannot get basic health care services.
The chapter avoids reporting findings or trends from the surveys, which have been published in a large number of academic papers, Foundation reports, and monographs. Instead, the chapter examines the evolution of the surveys and the shifting aims and priorities over the past 20 years. It highlights the challenges survey researchers face in studying access to health care, and it explains how approaches to measuring access also have evolved over the past two decades.
Authors Berk and Schur introduce readers to the logic of the Foundation's efforts in this area. It offers a guide to interpreting access-to-care research and puts the surveys supported by the Foundation into the context of other data collection efforts that have measured service use, access and expenditures on health care over the years.