AIDS Law Project Healthcare Access

Healthcare Access

Healthcare Access

Healthcare Access is a broad term that refers to the ability of individuals to obtain, use and benefit from medical services. It has been defined in many ways and opinions differ regarding what should be included within the concept. Some authors emphasise the role of individual characteristics in determining accessibility while others see it as an attribute of services or even goods that should be amenable to policy and organisational intervention.

The first approach views access as a function of supply and demand. According to this view, health care is just like any other consumer product — people can only afford what they can get. The other view is that health care is a right and should be provided to everyone, regardless of their ability to pay. A third view is that health care should be distributed based on need rather than capacity to pay.

For most people, health is a fundamental aspect of well being and an essential component of life. Hence, it is no surprise that the majority of people agree on the need for access to affordable healthcare. But the question is how should health care be financed and what form should it take?

Some authors define healthcare access as the ability to utilise appropriate and acceptable services that meet specific needs. This definition differs from that of other authors who stress the importance of the availability, accommodation and affordability of health services in a certain area or time. The latter definition has the advantage that it is amenable to policy and organisational interventions.

This article uses the latter approach, viewing access as a combination of the capability of individuals to seek and engage with health care, the availability of health care facilities and the ability to pay for these services. It is argued that this combination consists of five corresponding abilities of persons and their interaction with the dimensions of accessibility:

The ability to perceive, understand and communicate. The ability to perceive involves the capability of a person to be aware of the need for medical attention and to identify the symptoms that indicate a potential health problem. The ability to understand and communicate relates to a person’s level of comprehension of his or her illness and the capability of communicating these issues to a doctor or other health care professional.

The availability of health care services relates to the geographic and organisational distribution of medical facilities as well as their costs. The availability of healthcare is also influenced by the level of service available and by the capacity to travel to these facilities. The ability to reach health facilities can be impeded by financial, organizational or cultural barriers.

The ability to pay relates to the capacity of individuals to pay for health care and to understand the cost of their treatment. This dimension is influenced by the presence of debt, insurance and the cost of living. Finally, the ability to engage with health care is a key factor in access and it is influenced by capacity and motivation for self-care, self-management and the involvement of patients in their own decisions.