[Link between dimensions and stages of access to health goods and services: a conceptual delimitation].

Abstract

Objective: Access to healthcare can be interpreted as the interaction between need, demand and the supply of services, and involves passing through different stages. However, the journey through these stages can be threatened (or facilitated) by the influence of dimensions such as acceptability, availability, accessibility, adaptation, and appropriateness. The aim of this work is to identify which dimensions are activated at each stage of the access process.

Methods: A bibliographic review was conducted in Spanish and English using the Lilacs, PubMed databases, and the general search engine Google Scholar. Out of a total of seventy-four articles, twenty-one were selected based on inclusion and exclusion criteria.

Results: It was found that, at the need stage, dimensions of acceptability and appropriateness could be activated; the perception stage could be influenced by the dimension of acceptability; the stage of seeking care could be affected by the dimensions of acceptability, availability, accessibility, and adaptation; the stage of utilizing services is influenced by the dimensions of availability, accessibility, and adaptation, while the outcomes stage is impacted by the dimensions of acceptability and appropriateness.

Conclusions: Identifying the dimensions that can be activated at each stage of the access process to healthcare services is useful for decision-makers aiming to design policies that optimize patient navigation through the healthcare system by enhancing facilitating actions and/or minimizing obstructive measures.