The Concept of Access

TLDR

Access is a key concept in health policy and services research, yet it lacks a precise definition and scholars differ on whether it denotes entry into the system or the factors that influence such entry. This article proposes a taxonomic definition of “access.” Access is defined as a general concept comprising five dimensions—availability, accessibility, accommodation, affordability, and acceptability—and interview data on patient satisfaction were used to test the discriminant validity of these dimensions. The study found clear differentiation among the five dimensions and demonstrated that the measures correlate with the phenomena they intend to capture.

Abstract

Access is an important concept in health policy and health services research, yet it is one which has not been defined or employed precisely. To some authors "access" refers to entry into or use of the health care system, while to others it characterizes factors influencing entry or use. The purpose of this article is to propose a taxonomic definition of "access." Access is presented here. as a general concept that summarizes a set of more specific dimensions describing the fit between the patient and the health care system. The specific dimensions are availability, accessibility, accommodation, affordability and acceptability. Using interview data on patient satisfaction, the discriminant validity of these dimensions is investigated. Results provide strong support for the view that differentiation does exist among the five areas and that the measures do relate to the phenomena with which they are identified.