title: What does 'access to health care' mean?
abstract: Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration.
authors.affiliation: Department of Public Health Sciences, King's College London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Gulliford
authors.forename: Jose
authors.initials: J
authors.lastname: Figueroa-Munoz
authors.forename: Myfanwy
authors.initials: M
authors.lastname: Morgan
authors.forename: David
authors.initials: D
authors.lastname: Hughes
authors.forename: Barry
authors.initials: B
authors.lastname: Gibson
authors.forename: Roger
authors.initials: R
authors.lastname: Beech
authors.forename: Meryl
authors.initials: M
authors.lastname: Hudson
mesh_terms: D015276:Health Care Rationing; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D012935:Social Justice; D013222:State Medicine / Q000592:standards*; D014481:United States