Access as a policy-relevant concept in low- and middle-income countries

Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidime...

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Bibliographic Details
Published in:Health economics, policy and law policy and law, 2009-04, Vol.4 (2), p.179-193
Main Authors: MCINTYRE, DI, THIEDE, MICHAEL, BIRCH, STEPHEN
Format: Article
Language:English
Subjects:
Access to health care
Access to Information
Community
Dental care
Developing countries
Developing Countries - economics
Empowerment
Health care
Health care access
Health care policy
Health economics
Health policy
Health Policy - economics
Health Services Accessibility - economics
Health Services Needs and Demand - economics
Health services utilization
Households
Humans
Low income groups
Patient Acceptance of Health Care
Population
Shadow prices
Social Class
Studies
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Summary:Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit) between health care systems and individuals, households, and communities. Three dimensions of access are identified: availability, affordability, and acceptability, through which access can be evaluated directly instead of focusing on utilisation of care as a proxy for access. We present the case for the comprehensive evaluation of health care systems as well as the dimensions of access, and the factors underlying each dimension. Such systemic analyses can inform policy-makers about the ‘fit’ between needs for health care and receipt of care, and provide the basis for developing policies that promote improvements in the empowerment to use care.
ISSN:1744-1331
1744-134X
DOI:10.1017/S1744133109004836