Access to quality health services: determinants of access.

Access to health care has been the focus of national health policy in recent years, but little attention has been given to local communities and their access issues. This study offers a conceptual framework and an empirical analysis to identify the independent effect of predisposing, enabling, and medical need factors on access to care in a local community. In addition, access limitations related to the health plan and individual providers are incorporated into the access model. A hierarchical logistic regression is used in which the dichotomous dependent variable-residents' overall satisfaction with access to health care is regressed on five blocks of predictor variables. The most influential variables on access are enabling and health plan variables.