Russell Deborah J, Humphreys John S, Ward Bernadette, Chisholm Marita, Buykx Penny, McGrail Matthew, Wakerman John
School of Rural Health, Monash University, Centre of Research Excellence in Rural and Remote Primary Health Care, Bendigo, Victoria, Australia.
Aust J Rural Health. 2013 Apr;21(2):61-71. doi: 10.1111/ajr.12023.
This paper provides a comprehensive review of the key dimensions of access and their significance for the provision of primary health care and a framework that assists policy-makers to evaluate how well policy targets the dimensions of access. Access to health care can be conceptualised as the potential ease with which consumers can obtain health care at times of need. Disaggregation of the concept of access into the dimensions of availability, geography, affordability, accommodation, timeliness, acceptability and awareness allows policy-makers to identify key questions which must be addressed to ensure reasonable primary health care access for rural and remote Australians. Evaluating how well national primary health care policies target these dimensions of access helps identify policy gaps and potential inequities in ensuring access to primary health care. Effective policies must incorporate the multiple dimensions of access if they are to comprehensively and effectively address unacceptable inequities in health status and access to basic health services experienced by rural and remote Australians.
本文全面回顾了医疗服务可及性的关键维度及其对提供初级卫生保健的重要性，并提供了一个框架，以协助政策制定者评估政策在这些可及性维度上的目标达成情况。医疗服务可及性可被理解为消费者在需要时获取医疗服务的潜在便利程度。将可及性概念细分为可获得性、地理因素、可负担性、设施条件、及时性、可接受性和认知度等维度，有助于政策制定者确定关键问题，这些问题必须得到解决，以确保澳大利亚农村和偏远地区居民能够合理地获得初级卫生保健服务。评估国家初级卫生保健政策在这些可及性维度上的目标达成情况，有助于识别政策差距以及在确保获得初级卫生保健服务方面潜在的不公平现象。有效的政策必须纳入可及性的多个维度，才能全面、有效地解决澳大利亚农村和偏远地区居民在健康状况以及获得基本卫生服务方面存在的不可接受的不公平问题。
