Definitions and components of the dimensions of access25 27
| Accessibility of health services | Definitions and components | Abilities of individuals/patients to access health services | Definitions and components |
| Approachability | Health services need to exist, be known to individuals with healthcare needs, can be reached and can impact on their health. Components: provision of information by health services regarding available treatments and services to defined population groups, outreach activities. | Ability to perceive | The ability of individuals to identify their healthcare needs. Components: health and health service literacy. |
| Acceptability | The cultural and social factors that determine whether or not individuals accept aspects of the service. Components: individual (eg, sex and ethnicity of healthcare professional) and organisational (eg, primary care clinic not culturally responsive) aspects. | Ability to seek | The ability of individuals to express their intention to obtain healthcare Components: education regarding aspects of healthcare specific to individual’s needs and self-management plans. |
| Availability and accommodation | Health services (the physical facilities or healthcare staff) can be reached in a timely manner. Components: characteristics of the healthcare facilities (eg, location, physical accessibility), ways of delivering services (eg, face-to-face, virtual consultations) and healthcare staff (eg, working hours). | Ability to reach | The ability of individuals to physically reach their healthcare provider. Components: personal mobility, availability of transport, ability to take time off work to travel to and attend services. |
| Affordability | The economic capacity for people to spend resources and time to use appropriate services. Components: direct costs of accessing service (user charges), opportunity costs relating to loss of income (time off work, costs of travel). | Ability to pay | The ability of individuals to pay for healthcare services without detrimental expenditure on basic necessities (eg, food, accommodation). Components: out-of-pocket costs. |
| Appropriateness | The fit between services and clients’ need, its timeliness, the amount of care spent in assessing health problems and determining the correct treatment and the technical and interpersonal quality of the services provided. Components: comprehensiveness and integration of care across different healthcare providers. | Ability to engage | The ability of individuals to participate in and be involved in decision-making and treatment decisions around care. Components: individual actively involved in decisions about care (eg, goal setting, any action plans). |