Proposed emergency care access measures for monitoring, evaluation and comparative analysis by access type
Access type | Definition from penchansky and thomas | Adapted definition for emergency care | Proposed sample emergency care access measures |
Availability | The relationship of the volume and type of existing services to the clients’ volume and types of needs | The relationship between EU services and those seeking EC. | No of EC beds per catchment area |
Presence of drug, technology or interventions specific to EC | |||
Presence of EC clinicians 24 hours a day | |||
Per cent of clinicians with EC training | |||
Accessibility | The relationship between the location of supply and the location of clients, taking account of client transportation resources and travel time, distance and cost | The proximity (in time and space) of a patient to EU care. | Distance to closest emergency care facility |
Time to closest emergency care facility | |||
Available transport | |||
Time associated with transport | |||
Cost of transport to emergency care | |||
Affordability | The relationship of prices of services and providers’ insurance or deposit requirements to the clients' income, ability to pay and existing health insurance. | The cost of EU services and care, relative to patient’s household income and ability to pay. | Cost to access initial EC service |
Cost of individual services specific to EC (specific to individual care type) | |||
Overall EC cost per visit | |||
Accommodation | The relationship between the manner in which the supply resources are organised to accept clients (including appointment systems, hours of operation, walk-in facilities, telephone services) and the clients’ ability to accommodate to these factors and the clients’ perception of their appropriateness | The manner in which EU services are organised (time of operation, level of training and services able to be rendered) relative to a patient’s need. | Hours of operation of EU |
No of transfers per patient | |||
Average EU time to provider | |||
Training provided per specific EU interventions | |||
Acceptability | The relationship of clients’ attitudes about personal and practice characteristics of existing providers, as well as to provider attitudes about acceptable personal characteristics of clients | The relationship between a patient’s individual belief system and larger sociocultural attributes and their willingness to seek EC. | Understanding of how to navigate EC system |
Acceptability of EU care | |||
Acceptability of EU conduct or attitudes | |||
Acceptability of ambulance use |
EC, Emergency Care; EU, Emergency Unit.