Table 1 Four core dimensions of access [22]

Adequacy of Supply

If services are available and supply is adequate, then patients have the opportunity to obtain health care. In this situation a population may 'have access' to health care.

Barriers to Access

‘Gaining access’ may be dependent on barriers, including financial, organisational and social or cultural barriers, as well as adequacy of supply.

Effectiveness

Services must be clinically effective if access to health care is to lead to access to ‘satisfactory health outcomes'.

Equity

Equity may be measured in terms of availability, utilisation or outcomes. Both horizontal (equal treatment for equal groups) and vertical (unequal treatment of unequal groups) equity require consideration.