BACKGROUND: Access is central to the performance of health care
systems around the world. However, access to health care remains
a complex notion as exemplified in the variety of interpretations
of the concept across authors. 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. METHODS: A synthesis of the
published literature on the conceptualisation of access has been
performed. The most cited frameworks served as a basis to develop
a revised conceptual framework. RESULTS: 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. We conceptualise
five dimensions of accessibility: 1) Approachability; 2)
Acceptability; 3) Availability and accommodation; 4)
Affordability; 5) Appropriateness. In this framework, five
corresponding abilities of populations interact with the
dimensions of accessibility to generate access. 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. CONCLUSIONS: 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.
%0 Journal Article
%1 Levesque2013-gi
%A Levesque, Jean-Frederic
%A Harris, Mark F
%A Russell, Grant
%D 2013
%J Int. J. Equity Health
%K access care
%P 18
%T Patient-centred access to health care: conceptualising access at
the interface of health systems and populations
%V 12
%X BACKGROUND: Access is central to the performance of health care
systems around the world. However, access to health care remains
a complex notion as exemplified in the variety of interpretations
of the concept across authors. 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. METHODS: A synthesis of the
published literature on the conceptualisation of access has been
performed. The most cited frameworks served as a basis to develop
a revised conceptual framework. RESULTS: 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. We conceptualise
five dimensions of accessibility: 1) Approachability; 2)
Acceptability; 3) Availability and accommodation; 4)
Affordability; 5) Appropriateness. In this framework, five
corresponding abilities of populations interact with the
dimensions of accessibility to generate access. 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. CONCLUSIONS: 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.
@article{Levesque2013-gi,
abstract = {BACKGROUND: Access is central to the performance of health care
systems around the world. However, access to health care remains
a complex notion as exemplified in the variety of interpretations
of the concept across authors. 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. METHODS: A synthesis of the
published literature on the conceptualisation of access has been
performed. The most cited frameworks served as a basis to develop
a revised conceptual framework. RESULTS: 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. We conceptualise
five dimensions of accessibility: 1) Approachability; 2)
Acceptability; 3) Availability and accommodation; 4)
Affordability; 5) Appropriateness. In this framework, five
corresponding abilities of populations interact with the
dimensions of accessibility to generate access. 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. CONCLUSIONS: 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.},
added-at = {2022-03-31T03:33:23.000+0200},
author = {Levesque, Jean-Frederic and Harris, Mark F and Russell, Grant},
biburl = {https://www.bibsonomy.org/bibtex/258e9cb4e0114a3c85e6f28ebd3215c54/arinbasu},
interhash = {5f4ab4551c5f4ab3ffb20383d295ca27},
intrahash = {58e9cb4e0114a3c85e6f28ebd3215c54},
journal = {Int. J. Equity Health},
keywords = {access care},
language = {en},
month = mar,
pages = 18,
timestamp = {2022-03-31T03:33:23.000+0200},
title = {Patient-centred access to health care: conceptualising access at
the interface of health systems and populations},
volume = 12,
year = 2013
}