Health Care Access Paper
Patient-centred access to health care
Abstract
Background
Global health systems depend on access. Access to health care is difficult, as shown by authors’ different interpretations. This paper proposes a conceptualization of access to health care that integrates demand and supply-side factors and enables its operationalization throughout the process of receiving care and benefiting from it.
Methods
Access conceptualization literature was synthesized. A updated conceptual framework was based on the most-cited frameworks.
Results
Access means the chance to identify healthcare needs, seek services, reach, get, or use them, and have a need met. Accessibility has five dimensions: approachability, acceptability, availability and accommodation, affordability, and appropriateness. Access is created by five population abilities and accessibility dimensions. 1) Perception; 2) Seek; 3) Reach; 4) Pay; and 5) Engage.
Conclusions
This paper describes the comprehensiveness and dynamic nature of this conceptualization of access to care and identifies relevant determinants that can affect access from a multilevel perspective, including health systems, institutions, organizations, and providers as well as individual, household, community, and population factors.
Background
Healthcare systems worldwide depend on access. Service delivery is so important that health policy literature emphasizes utilisation and access measurement. Access to health care is difficult, as authors’ interpretations show.
Access means the right to enter, use, or approach a location. Health care access is always described as the opportunity or ease with which consumers or communities can use suitable services in proportion to their requirements.
Access has many definitions. Access is often used to describe factors or characteristics influencing the initial contact or use of services, but opinions differ on what should be included and whether the focus should be on provider characteristics or care. Health services can be used by patients, according to certain authors. Most authors acknowledge that user and provider characteristics affect access, but many focus on health care resource characteristics that affect service use, acting as a mediator between production and consumption. Penchansky was among those who clearly conceptualized access as the match between provider and health service features and consumer traits and expectations. Access to health care resources is influenced by both providers and users.
Health care access is typically characterized as need-based utilization. It can also mean care expenses, maximum consumption, or foregone utility.
Mooney believes supply and demand determine access. In this approach, access to health care is a product of supply variables, such as the location, availability, cost, and appropriateness of services, and demand factors, such as illness burden and knowledge, attitudes, skills, and self-care behaviors
This is consistent with predisposing variables to usage and enabling and health system factors. Perception of sickness and population-specific cultural, socioeconomic, and epidemiological factors predispose. Enablers include health service access. Health system factors include resources, structures, institutions, procedures, and rules for health services
Frenk defines access as people’s ability to get care. Thus, it describes a service user population’s utilization power and resistance. A theoretically appealing way to view access is as the degree of adjustment between the characteristics of the population and those of the health care resources, which reflects the differential existence either of obstacles, impediments, and difficulties or of factors that facilitate health care beneficiaries
