Patient-centred access to health care: conceptualising access at the interface of health systems and populations.
Patient-centred access to health care: conceptualising access at the interface of health systems and populations.
复制标题
DOI：
10.1186/1475-9276-12-18
复制
发表时间：
2013-03-11
影响因子：
4.8
通讯作者：
Russell G
中科院分区：
文献类型：
--
作者：
Levesque JF;Harris MF;Russell G
可及性是全世界卫生保健系统绩效的核心。然而，获得医疗保健仍然是一个复杂的概念，不同作者对这一概念的解释各不相同。本文的目的是提出一个概念化的获得医疗保健描述广泛的层面和决定因素，整合需求和供应方的因素，并使操作化的获得医疗保健的所有沿着过程中获得护理和受益于服务。已经完成了关于获取概念化的已发表文献的综合。被引用最多的框架是制定订正概念框架的基础。在这里，我们认为访问的机会，以确定医疗保健需求，寻求医疗保健服务，达到，获得或使用医疗保健服务，并实际上有一个需要的服务满足。我们将无障碍的五个方面概念化：1）可接近性; 2）可接受性; 3）可用性和住宿; 4）负担能力; 5）适当性。在这一框架中，人口的五种相应能力与无障碍环境的各个方面相互作用，产生无障碍环境。能力的五个必然维度包括：1）感知能力; 2）寻求能力; 3）到达能力; 4）支付能力; 5）参与能力。本文解释了全面性和动态性的概念化获得保健，并确定相关的决定因素，可以有一个多层次的角度来看，与卫生系统，机构，组织和供应商的因素与个人，家庭，社区和人口水平的因素考虑访问的影响。
Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels.
登录
查看更多内容
影响因子：
2.4
作者：
Gulliford, Martin;Figueroa-Munoz, Jose;Hudson, Meryl
通讯作者：
Hudson, Meryl
DOI：
10.2307/3349700
发表时间：
1982-01-01
期刊：
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY
影响因子：
--
作者：
DANIELS, N
通讯作者：
DANIELS, N
影响因子：
5.4
作者：
Goddard, M;Smith, P
通讯作者：
Smith, P
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM
影响因子：
6.3
作者：
Oliver, A;Mossialos, E
通讯作者：
Mossialos, E