title: The 3 A's of the access process to long-term care for elderly: providers experiences in a multiple case study in the Netherlands.
abstract: The access process is an important step in the care provision to independently living elderly. Still, little attention has been given to the process of access to long-term care for older clients. Access can be described by three dimensions: availability, affordability and acceptability (three A's). In this paper we address the following question: How do care providers take the three dimensions of access into account for the access process to their care and related service provision to independently living elderly? To answer this question we performed a qualitative study. We used data gathered in a multiple case study in the Netherlands. This study provides insight in the way long-term care organizations organize their access process. Not all dimensions were equally present or acknowledged by the case organizations. The dimension acceptability seems an important dimension in the access process, as shown by the efforts done in building a relationship with their clients, mainly through a strong personal relationship between client and care advisor. In that respect it is remarkable that the case organizations do not structurally evaluate their access process. Availability is compromised by practical issues and organizational choices. Affordability hardly seems an issue. Further research can reveal the underlying factors that influence the three A dimensions.
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbox 90153, 5000 LE Tilburg, The Netherlands; Surplus, Postbox 18, 4760 AA Zevenbergen, The Netherlands. Electronic address: e.c.c.schipper@tilburguniversity.edu.
authors.forename: Lisette
authors.initials: L
authors.lastname: Schipper
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbox 90153, 5000 LE Tilburg, The Netherlands. Electronic address: k.g.luijkx@tilburguniversity.edu.
authors.forename: Katrien
authors.initials: K
authors.lastname: Luijkx
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbox 90153, 5000 LE Tilburg, The Netherlands; Department Organization and Strategy, Tilburg School of Economics, Tilburg University, Postbox 90153, 5000 LE Tilburg, The Netherlands. Electronic address: b.r.meijboom@tilburguniversity.edu.
authors.forename: Bert
authors.initials: B
authors.lastname: Meijboom
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbox 90153, 5000 LE Tilburg, The Netherlands; Caphri, Department of Family Medicine and Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: j.m.g.a.schols@tilburguniversity.edu.
authors.forename: Jos
authors.initials: J
authors.lastname: Schols
mesh_terms: D000368:Aged; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration* / Q000600:supply & distribution; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D009426:Netherlands; D019982:Organizational Case Studies; D016134:Organizational Policy; D036301:Qualitative Research
keywords: Access to care; Long-term care; Older people; Welfare