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Assessing healthcare access using the Levesque’s conceptual framework– a scoping review
INTRODUCTION: Countries are working hard to improve access to healthcare through Universal Healthcare Coverage. To genuinely address the problems of healthcare access, we need to recognize all the dimensions and complexities of healthcare access. Levesque’s Conceptual Framework of Access to Health i...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103766/ https://www.ncbi.nlm.nih.gov/pubmed/33962627 http://dx.doi.org/10.1186/s12939-021-01416-3 |
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author | Cu, Anthony Meister, Sofia Lefebvre, Bertrand Ridde, Valéry |
author_facet | Cu, Anthony Meister, Sofia Lefebvre, Bertrand Ridde, Valéry |
author_sort | Cu, Anthony |
collection | PubMed |
description | INTRODUCTION: Countries are working hard to improve access to healthcare through Universal Healthcare Coverage. To genuinely address the problems of healthcare access, we need to recognize all the dimensions and complexities of healthcare access. Levesque’s Conceptual Framework of Access to Health introduced in 2013 provides an interesting and comprehensive perspective through the five dimensions of access and the five abilities of the population to access healthcare. The objectives of this paper are to identify and analyze all empirical studies that applied Levesque’s conceptual framework for access to healthcare and to explore the experiences and challenges of researchers who used this framework in developing tools for assessing access. METHODS: A scoping review was conducted by searching through four databases, for studies citing Levesque et al. 2013 to select all empirical studies focusing on healthcare access that applied the framework. An initial 1838 documents underwent title screening, followed by abstract screening, and finally full text screening by two independent reviewers. Authors of studies identified from the scoping review were also interviewed. RESULTS: There were 31 studies identified on healthcare access using the Levesque framework either a priori, to develop assessment tool/s (11 studies), or a posteriori, to organize and analyze collected data (20 studies). From the tools used, 147 unique questions on healthcare access were collected, 91 of these explored dimensions of access while 56 were about abilities to access. Those that were designed from the patient’s perspective were 73%, while 20% were for health providers, and 7% were addressed to both. Interviews from seven out of the 26 authors, showed that while there were some challenges such as instances of categorization difficulty and unequal representation of dimensions and abilities, the overall experience was positive. CONCLUSION: Levesque’s framework has been successfully used in research that explored, assessed, and measured access in various healthcare services and settings. The framework allowed researchers to comprehensively assess the complex and dynamic process of access both in the health systems and the population contexts. There is still potential room for improvement of the framework, particularly the incorporation of time-related elements of access. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-021-01416-3. |
format | Online Article Text |
id | pubmed-8103766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81037662021-05-10 Assessing healthcare access using the Levesque’s conceptual framework– a scoping review Cu, Anthony Meister, Sofia Lefebvre, Bertrand Ridde, Valéry Int J Equity Health Review INTRODUCTION: Countries are working hard to improve access to healthcare through Universal Healthcare Coverage. To genuinely address the problems of healthcare access, we need to recognize all the dimensions and complexities of healthcare access. Levesque’s Conceptual Framework of Access to Health introduced in 2013 provides an interesting and comprehensive perspective through the five dimensions of access and the five abilities of the population to access healthcare. The objectives of this paper are to identify and analyze all empirical studies that applied Levesque’s conceptual framework for access to healthcare and to explore the experiences and challenges of researchers who used this framework in developing tools for assessing access. METHODS: A scoping review was conducted by searching through four databases, for studies citing Levesque et al. 2013 to select all empirical studies focusing on healthcare access that applied the framework. An initial 1838 documents underwent title screening, followed by abstract screening, and finally full text screening by two independent reviewers. Authors of studies identified from the scoping review were also interviewed. RESULTS: There were 31 studies identified on healthcare access using the Levesque framework either a priori, to develop assessment tool/s (11 studies), or a posteriori, to organize and analyze collected data (20 studies). From the tools used, 147 unique questions on healthcare access were collected, 91 of these explored dimensions of access while 56 were about abilities to access. Those that were designed from the patient’s perspective were 73%, while 20% were for health providers, and 7% were addressed to both. Interviews from seven out of the 26 authors, showed that while there were some challenges such as instances of categorization difficulty and unequal representation of dimensions and abilities, the overall experience was positive. CONCLUSION: Levesque’s framework has been successfully used in research that explored, assessed, and measured access in various healthcare services and settings. The framework allowed researchers to comprehensively assess the complex and dynamic process of access both in the health systems and the population contexts. There is still potential room for improvement of the framework, particularly the incorporation of time-related elements of access. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-021-01416-3. BioMed Central 2021-05-07 /pmc/articles/PMC8103766/ /pubmed/33962627 http://dx.doi.org/10.1186/s12939-021-01416-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Cu, Anthony Meister, Sofia Lefebvre, Bertrand Ridde, Valéry Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title | Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title_full | Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title_fullStr | Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title_full_unstemmed | Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title_short | Assessing healthcare access using the Levesque’s conceptual framework– a scoping review |
title_sort | assessing healthcare access using the levesque’s conceptual framework– a scoping review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103766/ https://www.ncbi.nlm.nih.gov/pubmed/33962627 http://dx.doi.org/10.1186/s12939-021-01416-3 |
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