Improving access: modifying Penchansky and Thomas's Theory of Access

J Health Serv Res Policy. 2016 Jan;21(1):36-9. doi: 10.1177/1355819615600001. Epub 2015 Sep 15.


Access is defined as the degree of fit between the user and the service; the better the fit, the better the access. Using the theory developed by Penchansky and Thomas, access is optimized by accounting for the different dimensions of access: accessibility; availability; acceptability; affordability; and adequacy in service design, implementation and evaluation. These dimensions are independent yet interconnected and each is important to assess the achievement of access. However, I argue that one dimension is missing - awareness. I propose that awareness is integral to access, that it should become a permanent part of the theory, and be applied whenever using the theory to develop, implement, or evaluate health care services and access more generally.

Keywords: Access; health services; theory.

Publication types

  • Research Support, Non-U.S. Gov't