title: Improving access: modifying Penchansky and Thomas's Theory of Access.
abstract: Access is defined as the degree of fit between the user and the service; the better the fit, the better the access. Using the theory developed by Penchansky and Thomas, access is optimized by accounting for the different dimensions of access: accessibility; availability; acceptability; affordability; and adequacy in service design, implementation and evaluation. These dimensions are independent yet interconnected and each is important to assess the achievement of access. However, I argue that one dimension is missing - awareness. I propose that awareness is integral to access, that it should become a permanent part of the theory, and be applied whenever using the theory to develop, implement, or evaluate health care services and access more generally.
authors.affiliation: Broken Hill University Department of Rural Health, University of Sydney, Australia emily.saurman@sydney.edu.au.
authors.forename: Emily
authors.initials: E
authors.lastname: Saurman
keywords: Access; health services; theory