ArticleHealth expectations : an international journal of public participation in health care and health policy2017
Validation of a new measure of availability and accommodation of health care that is valid for rural and urban contexts.
Article in Health expectations : an international journal of public participation in health care and health policy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Methods for modelling composite indices of access to healthcare facilities: a systematic literature review.Population health metrics · 2025Pooled it
- Factors associated with unmet healthcare needs in patients using Primary Care Access Points for unattached patients in Quebec (Canada).PloS one · 2026Article
- Understanding inequitable health care: methodological approaches, challenges, and opportunities.American journal of epidemiology · 2025Article
- Article
- Adaptation and Psychometric Assessment of the Turkish Version of the Perceived Access to Health Care Questionnaire: Validity and Reliability Analysis.Healthcare (Basel, Switzerland) · 2025Article
- Profiling patterns of patient experiences of access and continuity at team-based primary healthcare clinics (Canada): a latent class analysis.International journal for equity in health · 2024Article
- Patients Living with Social Vulnerabilities Experience Reduced Access at Team-Based Primary Healthcare Clinics.Healthcare policy = Politiques de sante · 2023Article
- Perceived Access and Appropriateness: Comparison of Teaching and Resident Family Physicians' Patients.Family medicine · 2023Article
- Impact of externally facilitated continuous quality improvement cohorts on Advanced Access to support primary healthcare teams: protocol for a quasi-randomized cluster trial.BMC primary care · 2023Article
- Article
- Health-care access dimensions and ovarian cancer survival: SEER-Medicare analysis of the ORCHiD study.JNCI cancer spectrum · 2023Article
- Development and calibration data for the Healthcare Access Item Bank: a new computer adaptive test for persons with type 2 diabetes mellitus.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Content Validity of a Scale Designed to Measure the Access of Older Adults to Outpatient Health Services.International journal of environmental research and public health · 2022Article
- Are Family Medicine Clinics Improving Access to Care through Organizational Changes Driven by Healthcare Reform?Healthcare policy = Politiques de sante · 2022Observational
- Comparing the Attainment of the Patient's Medical Home Model across Regions in Three Canadian Provinces: A Cross-Sectional Study.Healthcare policy = Politiques de sante · 2021Article
- Interprofessional advanced access - a quality improvement protocol for expanding access to primary care services.BMC health services research · 2021Article
- Psychometric evaluation of the perceived access to health care questionnaire.BMC health services research · 2021Article
- Assessing healthcare access using the Levesque's conceptual framework- a scoping review.International journal for equity in health · 2021Article
- Instrument Development and Validation to Assess Care Barriers for Patients in Saudi Arabia with Oral Clefts.International journal of environmental research and public health · 2021Article
- Modelling Potential Geographical Access of the Population to Public Hospitals and Quality Health Care in Romania.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextPatients are the most valid source for evaluating the accessibility of services, but a previous study observed differential psychometric performance of instruments in rural and urban respondents.
objectiveTo validate a measure of organizational accessibility free of differential rural-urban performance that predicts consequences of difficult access for patient-initiated care.
designSequential qualitative-quantitative study. Qualitative findings used to adapt or develop evaluative and reporting items. Quantitative validation study.
settingPrimary data by telephone from 750 urban, rural and remote respondents in Quebec, Canada; follow-up mailed questionnaire to a subset of 316. MAIN MEASURES AND ANALYSES: Items were developed for barriers along the care trajectory. We used common factor and confirmatory factor analysis to identify constructs and compare models. We used item response theory analysis to test for differential rural-urban performance; examine individual item performance; adjust response options; and exclude redundant or non-discriminatory items. We used logistic regression to examine predictive validity of the subscale on access difficulty (outcome).
resultsInitial factor resolution suggested geographic and organizational dimensions, plus consequences of access difficulty. After second administration, organizational accommodation and geographic indicators were integrated into a 6-item subscale of Effective Availability and Accommodation, which demonstrates good variability and internal consistency (α = 0.84) and no differential functioning by geographic area. Each unit increase predicts decreased likelihood of consequences of access difficulties (unmet need and problem aggravation).
conclusionThe new subscale is a practical, valid and reliable measure for patients to evaluate first-contact health services accessibility, yielding valid comparisons between urban and rural contexts.
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