Rezumat articol ediţie STUDIA UNIVERSITATIS BABEŞ-BOLYAI

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Out of the social determinants of health, access to health care services is one of the most important. Seen in terms of the opportunity to reach and request such services, the access also covers the request of primary care and its use. The major dimensions of influencing the access are those coming from the medical system and health care policies, along with societal and individual determinants. This paper is based on qualitative data collected through two case studies conducted in two large cities from Romania, one from the North-West Development Region and the second from the North-East Development Region, using the method of in-depth personal interview. Major themes have sought to identify the perceptions of healthcare, public and private providers, access to primary health services and its problems, in particular the identification of vulnerable categories and the causes of vulnerability in the public health care system. The responses were interpreted through the lenses of social constructivism. They revealed that “vulnerability” does not have a uniform meaning and the cooperation between specialists in the medical, social, and socio-medical fields in public and private institutions is rather poor. The current health-insurance system hinders access even to primary health care services, increasing vulnerability to the worsening of health condition and epidemics. The recent medical reforms in Romania, praised for some of the changes, caused nevertheless also confusion and procedural inconsistencies, inequities between citizens and even providers of medical and medical-social care from the public and private sectors.

Keywords: vulnerability, risk, access, primary medical care services, communities at risk, social determinants