Table 1 Definitions and dimensions of access to health care
Authors | Definition | Dimensions |
|---|---|---|
Bashshur et al., 1971 | Accessibility as the functional relationship between the population and medical facilities and resources, and which reflects the differential existence either of obstacles, impediments and difficulties, or of factors that are facilitators for the beneficiaries of health care | |
Donabedian, 1973 | Accessibility comprising the concept of degree of adjustment between resources and populations | |
Salkever, 1976 | Accessibility combining attributes of the resources and attributes of the population | Financial accessibility |
Physical accessibility | ||
Aday & Andersen, 1974 | Access as entry into the health care system | Predisposing factors |
Enabling factors | ||
Need for health care | ||
Penchansky & Thomas, 1981 | Affordability Accessibility | |
Accommodation | ||
Availability | ||
Acceptability | ||
Dutton, 1986 | Utilisation viewed as the product of patients characteristics plus provider and system attributes | Financial |
Time | ||
Organizational factors | ||
Frenk, 1992 | Access as the ability of the population to seek and obtain care | |
Accessibility is the degree of adjustment between the characteristics of health care resources and those of the population within the process of seeking and obtaining care | ||
Margolis et al., 1995 | The timely use of personal health services to achieve the best possible outcomes. | Financial |
Personal | ||
Structural | ||
Haddad & Mohindra, 2002 | The opportunity to consume health goods and services | Availability |
Affordability | ||
Acceptability | ||
Adequacy | ||
Shengelia et al., 2003 | Coverage: probability of receiving a necessary health intervention, conditional on health care need | Physical access |
Resource availability | ||
Utilization: quantity of health care services and procedures used | Cultural acceptability | |
Financial affordability | ||
Quality of care | ||
Peters et al. 2008 | Access viewed as including actual use of services. A clear emphasis is given to consider both users and services characteristics in evaluation of access. The notion of fit between users and services is identified. | Quality |
Geographic accessibility | ||
Availability | ||
Financial accessibility | ||
Acceptability of services |