Barriers to accessing health care: the perspective of elderly people within a village community

Many initiatives which emphasise the consumerist stance of patients make the apparent assumption that patients have the knowledge and desire to exercise their consumer rights. This study explores the extent to which there is a consumerist ethos among elderly people in a village community, and the factors which influence the accessing of health care in the community. Using a mini-ethnographic approach, nine key informants were observed and interviewed. Cultural factors were found to influence coping in health and illness, and in legitimising access to primary health care. No informant saw the need to exercise their rights as consumers of health care, suggesting that despite initiatives to involve patients as partners in health care, the hierarchical position of the elderly people in the village is unchanged from the days of the medical model in health care, and is a significant barrier to their use of health services.