Measuring Access to Health Services: Constructing a Multidimensional Index

Abstract

Access to health services is a multidimensional and multistage phenomenon. Despite the extensive development of the theoretical framework of access to health care, until now, no indices have been developed to measure all its dimensions and stages. In this work, we propose an index for measuring the multidimensional access to health services, considering nine dimensions of this phenomenon and a questionnaire format that allows obtaining information for its calculation and application. The proposed index is continuous, monotonic, and can be decomposed according to dimensions and services. At the same time, our index considers the subjectivity in the patient valuation of each dimension throughout the different stages of health access. As a case study, we applied the proposed methodology to a medium-sized city in Argentina, determining the relationship of the index with socioeconomic factors and its spatial distribution. Although no clear geographic pattern emerged from the results, statistically significant relationships were found with socioeconomic factors such as gender identity, educational level, activity status, and type of health insurance of the household head.