![]() Some authors view access more as an attribute of health services, noting the fact that services can be accessed or utilised by those requiring care. While the term access is often used to describe factors or characteristics influencing the initial contact or use of services, opinions differ regarding aspects included within access and whether the emphasis should be put more on describing characteristics of the providers or the actual process of care. Īccess has been conceptualised in numerous ways. Within health care, access is always defined as access to a service, a provider or an institution, thus defined as the opportunity or ease with which consumers or communities are able to use appropriate services in proportion to their needs. Įtymologically, access is defined as a way of approaching, reaching or entering a place, as the right or opportunity to reach, use or visit. ![]() However, access to health care remains a complex notion as exemplified by the varying interpretations of the concept across authors. In fact, the importance of service delivery for people has resulted in measurement of utilisation and access having a prominent role in the health policy literature. This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels.Īccess to healthcare is central in the performance of health care systems around the world. Five corollary dimensions of abilities include: 1) Ability to perceive 2) Ability to seek 3) Ability to reach 4) Ability to pay and 5) Ability to engage. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. ![]() We conceptualise five dimensions of accessibility: 1) Approachability 2) Acceptability 3) Availability and accommodation 4) Affordability 5) Appropriateness. Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. The most cited frameworks served as a basis to develop a revised conceptual framework. MethodsĪ synthesis of the published literature on the conceptualisation of access has been performed. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. Access is central to the performance of health care systems around the world.
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