Hence, access is considered one of the main public policy issues in setting priorities or evaluating the healthcare systems performance [3]. 2023 Feb 1;24(1):38. doi: 10.1186/s12875-023-01993-y. The next three dimensions are non-spatial and belong to cost, service quality, and cultural factors [14]. Nevertheless, the dimensions with low Cronbachs alpha need to be further examined in future studies. retrieved from: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=%22Exploratory+and+Confirmatory+Factor+Analysis%3A+Which+One+to+Use+First%3F%22&btnG. Hunter I, Lockhart C, Rao V, Tootell B, Wong S. JMIR Form Res. Penchansky and Thomas define acceptability as the relationship, between clients' attitudes about personal and practice characteristics of existing providers including age, sex, location and type of facility or religious affiliation of the provider or facility, as well as provider attitudes about acceptable personal characteristics of clients, Martin CR, Emily S-MG. A good practiceguide for the reporting of design and analysis for psychometric evaluation. Although these indicators show some of the available resources, they do not demonstrate anything about the quality of these resources or whether people should use them or not. Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. eCollection 2022 Dec. Tech Innov Patient Support Radiat Oncol. This site needs JavaScript to work properly. Improving access: modifying Penchansky and Thomas's Theory of Access J Health Serv Res Policy. It is used by Recording filters to identify new user sessions. The authors received no specific funding for this work. While the research literature suggests strong evidential support for several of the policy interventions discussed in this report, many of the most conceptually promising have been insufficiently studied to determine their effect on primary care access for underresourced communities. Random intercept multilevel logistic regression models were used to assess the association between individual- and village-level factors and likelihood of facility delivery. Nonfinancial Barriers and Access to Care for U.S. Adults Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study. Access refers to the ability to receive the appropriate care from a proper healthcare provider, at the right time and place, depending on the context [1]. For terms and use, please refer to our Terms and Conditions 2018 Jul 16;39:20. doi: 10.1186/s40985-018-0097-4. Fit indices were used in the confirmatory factor analysis with experimental data. https://doi.org/10.1371/journal.pone.0161553. retrieved from:. access to health care questionnaire Sara-Sadat Hoseini-Esfidarjani1, Reza Negarandeh1,2*, Farzaneh Delavar1 and Leila Janani3 Abstract Background and objective: Access to health care is a universal concern. Penchansky and Thomas described access to care as consisting of five . This is particularly true with regard to the access dimension of health performance, where research and policy focus almost exclusively on availability and affordability perspectives of access while neglecting demand- side aspects of health-seeking behaviour, such as acceptability. 2016;21(1):369. The initial questionnaire was examined using qualitative content validity, and the necessary modifications were applied to each item. Hoseini-Esfidarjani, SS., Negarandeh, R., Delavar, F. et al. Root mean square error of approximation (RMSEA) was less than 0.05. In general, access to health care services is traditionally measured using population-level parameters such as the availability, distribution, and proximity of health facilities to the population. PMID: 26377728 Data analysis was conducted using SPSS software version 24, R software version 4, and lavaan package. 2019;10(1):1626075. https://doi.org/10.1080/20008198.2019.1626075. They were asked to comment on the level of item difficulty, comprehensibility of the phrases and the words, the appropriateness and relatedness of the items, as well as the ambiguity and misinterpretation of the words and phrases. Would you like email updates of new search results? The opinion provided by the panel of experts in the field of access to health services, research, and psychometrics was obtained in terms of grammar, use of appropriate items and phrases, proper location of questionnaire items, and scoring procedure. Belgium: European Commission Brussels; 2007. retrieved from: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=%22Measuring+inequalities+in+access+to+health+care.+A+review+of+the+indices%22&btnG. Manuscript did not include details, images, or videos relating to an individual person. For example, network adequacy requirements can be a tool to ensure that those covered under insurance have timely and affordable access to primary care physicians near them. Public Health Rev. 2020;17(1):13. https://doi.org/10.1037/ser0000235. The Perceptions of Physician Influence on Healthcare Accessibility The first two dimensions (i.e., availability and accessibility) represent the geographic dimension of access. This cookie is installed by Google Analytics. Content validity, face validity, construct validity, internal consistency, and instrument reliability were further examined. In this study, the minimum ICC rate was considered 0.75 [26]. MeSH . For further explanation, it can be said that the availability dimension refers to the physical availability of health care resources with sufficient capacity to provide services [2]. Comparison of general and cardiac care-specific indices of spatial : Data analysis, revising of manuscript. R. N.: Conception & design, supervision of study, drafting and revising of manuscript. Through analyzing this concept, Penchansky and Thomas (1981) have defined five dimensions for access, including 1) availability, 2) accessibility, 3) affordability, 4) accommodation, and 5) acceptability [ 13 ]. The Dimensions of Access: Penchansky & Thomas (1981) presented 5 dimensions of access: Affordability. Therefore, this study was conducted to develop a questionnaire to assess the Perceived Access to Health care based on Penchansky and Thomass definition of access and the assessment of its psychometric properties. Medical Care A minimum of 400 million people worldwide is currently deprived of access to basic health care services. The Aday and Andersen definition has been further delineated into six dimensions according to the framework of access created by Penchansky and Thomas and augmented by Saurman (Penchansky and Thomas, 1981; Saurman, 2016). Access to health care services plays a crucial role in the healthcare systems efficiency worldwide [2]. National Library of Medicine In qualitative face validity, all items were approved by a panel of experts and the participants. Evaluating the perception of martyrs parents of access to the services of health monitoring plan provided by Foundation of Martyrs and Veterans Affair of 10 and 11 districts of Tehran in 2014. Method Search strategy Jenn NC. In this case, the clients perception of access to health care services is crucial because their perceptions affect when and where they should seek and receive health care services. tial care [8]. Access to health care is a universal concern. F1000Research. Development of the Perceived Access Inventory: A patient-centered measure of access to mental health care. According to the Penchansky and Thomas framework (1981,1984), health care access is a latent construct with 5 key dimensions: affordability, availability, accessibility, accommodation and acceptability [ 19, 20 ]. Access problems, especially in low-income countries, actually threaten the achievement of the goals that the United Nations set in the Millennium Development Goals [6]. J Reprod Infant Psychol. 2020;39(2):24055. 8600 Rockville Pike Cookies policy. Epub 2015 Sep 15. (2008), Obrist et al. This questionnaire is designed based on the modified Penchasky & Thomas model. However, I argue that one dimension is missing - awareness. However, access to this important source of care is lack-ing, especially for many underresourced groups, such as communities of color and in rural areas. Allin S, Cristina M, Corinna S, et al. This site needs JavaScript to work properly. 2016;11(8):e0161553. The https:// ensures that you are connecting to the FOIA Accordingly, the questionnaire for perception of access to health care services was developed in six subscales and 31 items in the present study: 1) availability which refers to the adequacy of supply and examines the available services and resources to meet the potential and actual needs of the consumers and communities; 2) accessibility which evaluates the available service in accordance with the reasonable proximity to the consumer in terms of time and distance; 3) affordability which refers to the direct costs to the health care providers and consumers; 4) accommodation which refers to the adequacy of classification of services in order to be accepted and used by the consumers; 5) acceptability which highlights the provider and consumers attitudes about the characteristics of the service as well as their social or cultural concerns; and 6) awareness represents the concept that services can help maintain awareness through effective communication and information strategies with the target users (physicians, patients, and the general public), including attention to health context and literacy [1]. It seems that the development of the model in the future can provide more clarity in the definition of its dimensions and help revise the questionnaire items accordingly. In the case of CVI, the items with a score higher than 0.79 were considered appropriate, the items with a score between 0.70 and 0.79 were considered as the items with the need to be revised, and the items with a score equal to and lower than 0.70 were considered as unacceptable items and were then removed. Am J Public Health. Besides, the internal correlation of the final questionnaire was examined, with 300 patients referred to the selected health centers. Medical Care, 19, 127-140. Relating Satisfaction With Access to Utilization of Services Google Scholar. Issues of accessibility to health services by older Australians: a review. The content of the questionnaire was examined in both quantitative and qualitative ways. The initial questionnaire was developed according to the five dimensions, which were introduced in Penchansky and Thomas model of access (1981), and the sixth dimension, which was introduced in Saurmans (2015) study [1]. Otieno PO, Achach WEO, Mohamed Shukri M, et al. 2018;9(4):41421. Spatial Accessibility of Primary Care in the Dual Public-Private Health System in Rural Areas, Malaysia. This was informed by the determinants of use as proposed by Andersen and other utilization theorists. How ChatGPT and AI are affecting the literary world Economic access is the financial affordability for the resources. Malaysian Fam Phys. It should also be noted that only 9 of the 15 experts invited to the panel responded. Perception enables judgment, and perception of access to health care services is, in fact, an alternative to demonstrating access to health care services that examines access management in a more straightforward way [11]. 2012 Feb;47(1 Pt 2):462-85. doi: 10.1111/j.1475-6773.2011.01308.x. Access index was constructed using principal component analysis and recoded into tertiles with categories labeled as poor, moderate and highest. Findings from the qualitative face validity showed that the panel of experts and participants approved the level of difficulty, the degree of appropriateness and ambiguity of the scale, and the 5-point Likert scale. Federal government websites often end in .gov or .mil. It can be concluded that the Perceived Access to Health care Questionnaire was developed with 30 items; it has acceptable content validity, face validity, construct validity, and reliability. To some authors "access" refers to entry into or use of the health care system, while to others it characterizes factors influencing entry or use. Author Emily Saurman 1 Affiliation 1 Broken Hill University Department of Rural Health, University of Sydney, Australia emily.saurman@sydney.edu.au. Manage cookies/Do not sell my data we use in the preference centre. AddThis sets this cookie to ensure that the updated count is seen when one shares a page and returns to it, before the share count cache is updated. These were then deductively organised according to Penchansky and Thomas's modified access model. Access your FREE ticket and reserve your seat below and join in for an evening of wine, networking The Effectiveness of Policies to Improve Primary Care Access for In this study, the questionnaire on the perception of access to health care services was developed, and its psychometric properties were examined. Model fit was considered good if the Tucker Lewis Index (TLI) [23], Normed-Fit Index (NFI), Non-Normed-Fit Index (NNFI), Goodness of Fit (GFI) were greater than or equal to 0.95. (2017) developed a scale to measure perceptions of access to health care services among the disabled and their non-disabled counterparts in Nigeria. 2017;20(2):32134. 2017;32(2):6. retrieved from https://egrove.olemiss.edu/jrss/vol32/iss2/6/. J Measurement Eval Educ Psychol. Historically, the concept of health care services access has had different definitions that correspond to each health systems structural values. This cookie is a browser ID cookie set by Linked share Buttons and ad tags. https://doi.org/10.1016/j.apnu.2013.05.001. They suggested that the concept of access was the "the degrees of fit between clients' needs and the health system's ability to meet those needs" (Penchansky and Thomas 1981, p. 128). Terry D, Kaye E, Alan C, et al. The authors have declared that no competing interests exist. A range of factors interact to influence a patient's ability to access health care at any point in time. Validity and reliability of instrument to measure social media skills among small and medium entrepreneurs at Pengkalan Datu River. To some authors "access" refers to entry into or use of the health care system, while to others it characterizes factors influencing entry or use. In addition, the Intra-Class Correlation Index (ICC) was calculated to determine the reliability of the instrument using the test-retest approach. https://doi.org/10.1080/00045608.2012.657146. Examining the Relationship between Access to Health Care and Socio retrieved from: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=%22A+simplified+guide+to+determination+of+sample+size+requirements+for+estimating+the+value+of+intraclass+correlation+coefficient%3A+a+review%22&btnG=. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. The cookie is used to store the user consent for the cookies in the category "Analytics". Improving access: modifying Penchansky and Thomas's Theory of Access L.J. Availability refers to the total number of services that the consumer can choose to receive. To prepare each issue, Publisher and Editor-in-Chief Neil Clarke and his staff read through the pieces and narrow down their selections for publication. Koo TK, Li Mae Y. The 5 A's of Access for Employer-Sponsored Healthcare Expanding access to health services with self-care interventions. 2022 Dec 2;24:131-136. doi: 10.1016/j.tipsro.2022.11.002. Table3shows the internal consistency of thePerception of Access to Health care servicesQuestionnaire using Cronbachs alpha. This cookie is set by GDPR Cookie Consent plugin. Barriers to health care access among the elderly and who perceives them. You also have the option to opt-out of these cookies. The proper use of health care services in different places and among different groups of people is considered a prerequisite for this success [40]. XIX, No. Nurs Pract Today. PubMed PDF Applying an Access Framework to Studying Equity at the Intersection of Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. In the quantitative face validity analysis, the item effect size was calculated, and all items were retained for the next steps since the obtained score for each of the 30 items was higher than 1.5. Correspondence to Some definitions address whether people actually use such services or not and define their use of services as access. According to Koo and Li, this rate indicates excellent reliability of the questionnaire [26]. Funding for this project was provided by the National Institute for Health Care Reform, This website uses cookies to gather statistical information to track usage and improve your experience. As a result, the remaining 30 (see technical appendix in Additional file 1) items in the content validity analysis were examined for face validity. Since the early 1970s, there has been extensive debate about the concept of health care access that still remains confusing [12]. ; The construct validity showed that the items of the questionnaire were related to the six-dimensional hypothetical structure based on models of access to health services [3]. In recent studies, this concept was introduced by describing broad dimensions. Disclaimer. Glob Health Sci Pract. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. Multivariable logistic regression models were used to . Improving access to school health services as perceived by school professionals. Importantly, unlike other models of access, the Penchansky and Thomas classification permits the assignment of any access barrier to a specific category with clear and actionable . 2013;27(4):17984. An official website of the United States government. These studies have only examined one or more access dimensions that could not cover all the present study areas. Accommodation -The extent to which the provider's operation is organized in ways that meet the preferences of the patient; this would include things like hours of operation, telephone/digital communication options, and the patient's ability to receive care without prior appointments. 1998;9:2839. 9781315169729_previewpdf - Read online for free. The construct validity determines the extent to which observational variables (items) can explain the studys main concept (the concept of perception of access to health care services). An integrated approach to multi-criteria-based health care facility location planning. Med Care. In both the quantitative and qualitative approaches to content validity, only one item was removed, while all the items were retained in the analysis of face validity. Mary Brown Walker. 2016;68(3):2606. They argue that the . The first two dimensions are spatial in nature. Jody Lori | University of Michigan - Academia.edu FOIA Given the importance of individuals perception of their access to health care services and the need to develop standard instruments to measure it, this study was conducted to develop and evaluate psychometric properties of the questionnaire to assess perceived access to health care services among the adults. Thiede M, Patricia A, Di MI, et al. 1080/ 00330120701724087. Bethesda, MD 20894, Web Policies Therefore, this study was conducted to develop a questionnaire to assess the Perceived Access to Health care based on Penchansky and Thomas's In qualitative content analysis, the questionnaire was reviewed, and the necessary corrections were applied to each item based on the opinions obtained from the panel of experts.
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