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Table 1 Definitions and dimensions of access to health care

From: Patient-centred access to health care: conceptualising access at the interface of health systems and populations

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
Dutton, 1986 Utilisation viewed as the product of patients characteristics plus provider and system attributes Financial
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
Haddad & Mohindra, 2002 The opportunity to consume health goods and services Availability
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
Financial accessibility
   Acceptability of services