Accessing Health Care in Global Public Health: The History of Conceptual Frameworks

Abstract

Access to health care is a complex notion that has been explained in different ways by different authors. In the literature, the terms “access,” “availability,” and “utilization” have been used interchangeably to illustrate whether people’s care-related needs are provided effectively by the available health care services. Conceptualizations of access seek to understand the common elements outside of specific contexts; these concepts are then applied in the particular local contexts. Access to health care is recognized as the key influential factor for improved population health outcomes and health care system sustainability. Generally, access to health care is measured in relation to the utilization or availability of health care services. Many researchers had developed multiple dimensions to measure access to health care such as the behavioral model of Aday and Anderson (1974), and the three barrier-focused models of Penchansky and Thomas (1981), Russell et al. (2013), and Saurman (2016). The conceptual frameworks of access to health are categorized into two core approaches, which are the system-centered approach and the patient-centered approach. This chapter provides the history of the conceptual frameworks of access to health care in global public health and discusses some empirical research that applied these frameworks. Measuring access to health care could recognize barriers, in turn contributing effectively to addressing difficulties in order to improve access to health care services to many individuals who are in need to sensitive health care in their everyday lives.