Objective: Equal access to health care is a central goal in socialized health systems like the one in Iceland. Previous research in Iceland indicates considerable individual and group differences in access to health care. The study maps the distribution of postponement and cancellation of physician care among Icelandic adults and considers a number of potential explanations.

Material and methods: The data come from a national postal health survey of Icelandic adults, age 18-75, who were randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate.

Results: 22% of the respondents had postponed or cancelled a physician visit they thought they needed in the past 6 months. The study found considerable variations in postponement rates. Postponement was positively related to younger age, full employment, financial difficulties, high out-of-pocket health care costs, inflexible daily schedules (fixed roles), dissatisfaction with last physician visit, and the number of chronic medical conditions experienced.

Conclusions: Postponement or cancellation of medical care is fairly common among Icelandic adults, although considerable individual and group differences in postponement are observed. The results raise concerns, as equal access to care is a central goal of the Icelandic health care system. It is incumbent upon health authorities to pursue effective ways to equalize access to medical care and prevent postponement and cancellation of needed services.

Table I: Delay/cancellation of a needed physician visit by explanatory variables

Table II. Logistic regression of postponement of a needed physician visit (stepwise selection) (N=941)^a