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Intended for healthcare professionals

Abstract

Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration.

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Article first published: July 2002
Issue published: July 2002

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© Royal Society of Medicine Press Limited 2002.
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PubMed: 12171751

Authors

Affiliations

Martin Gulliford
Department of Public Health Sciences, King's College London, UK
Jose Figueroa-Munoz
Department of Public Health Sciences, King's College London, UK
Myfanwy Morgan
Department of Public Health Sciences, King's College London, UK
David Hughes
Department of Public Health Sciences, King's College London, UK
Barry Gibson
Department of Dental Public Health, King's College London, UK
Roger Beech
Centre for Health Planning and Management, University of Keele, UK
Meryl Hudson
Department of Public Health Sciences, King's College London, UK

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