Table 2.

The concepts of access

Concept of access	Definition	Concept components and examples
Accessibility*	Location	An accessible service is within reasonable proximity to the consumer in terms of time and distance.
Availability*	Supply and demand	An available service has sufficient services and resources to meet the volume and needs of the consumers and communities served.
Acceptability*	Consumer perception	An acceptable service responds to the attitude of the provider and the consumer regarding characteristics of the service and social or cultural concerns. For instance, a patient’s willingness to see a female doctor may determine whether a service is acceptable or not.
Affordability*	Financial and incidental costs	Affordable services examine the direct costs for both the service provider and the consumer.
Adequacy* (Accommodation)	Organisation	An adequate service is well organised to accept clients, and clients are able to use the services. Considerations of adequacy include hours of operation (afterhour services), referral or appointment systems, and facility structures (wheelchair access).
Awareness**	Communication and information	A service maintains awareness through effective communication and information strategies with relevant users (clinicians, patients, the broader community), including consideration of context and health literacy.

*The five concepts of access identified by Penchansky and Thomas [36]. Penchansky, R. and J. W. Thomas. “The Concept of Access: Definition and Relationship to Consumer Satisfaction.” Medical Care 19(2): 127–140.

**Awareness, a sixth concept that may influence access.