Arabic Version of the Perceived Access to Health Care Questionnaire: Validation, Factor Analysis, and Rasch Modeling.

Abstract

Background: Access to healthcare is a critical determinant of individual and population health outcomes. However, few validated tools exist to evaluate healthcare access among Arabic-speaking populations.

Objectives: This study aimed to validate the Arabic version of the Perception of Access to Health Care Services Questionnaire (PAHSQ) and assess its psychometric properties, including reliability and construct validity, using factor and Rasch analyses.

Design: A cross-sectional study was conducted with 485 participants (53.4% female) recruited from hospitals and pharmacies in Jordan.

Methods: Confirmatory factor analysis (CFA) and Rasch analysis were employed to evaluate the construct validity and item performance of the 30-item, six-factor model. Internal consistency was assessed using Cronbach's alpha.

Results: The Arabic PAHSQ exhibited strong psychometric properties. CFA confirmed the suitability of the six-factor model (χ²/df = 3.2, RMSEA = 0.07, CFI = 0.93, TLI = 0.92). Cronbach's alpha values for the six dimensions ranged from 0.82 to 0.93. Rasch analysis demonstrated acceptable infit and outfit values for all items, with item thresholds correctly oriented. Key findings highlighted significant disparities in healthcare access, particularly among participants with low income and no insurance coverage.

Conclusions: The Arabic PAHSQ is a reliable and valid tool for assessing healthcare access among Arabic-speaking populations. Its use can inform targeted interventions, guide resource allocation, and support health equity initiatives. Further research should explore its applicability across diverse Arabic-speaking regions and incorporate qualitative methodologies to capture more subtle access barriers.