Definition of Access
Distance to health care providers, while a more significant problem in rural areas, remains an important factor in the spatial accessibility of a provider in urban areas (Guagliardo, Ronzio, Cheung, Chacko, & Joseph, 2004). Jarvis’s Law states that there is an inverse relationship between the distance to a service location and the rate of utilization of that service location. However, in order for the question of accessibility to exist, there must be a supply of service (Joseph & Phillips, 1984).
Access is composed of stages, potential and realized, and dimensions, spatial and aspatial. Potential access focuses on the possible use of health services. Realized access is how health services are used once all barriers are surmounted (Anthamatten & Hazen, 2011). There are five main barriers between potential access and realized access: three are aspatial (affordability, accommodation, and acceptability) and two are spatial (availability and accessibility) (Penchansky & Thomas, 1981). Guagliardo (2004) suggests that, in urban areas, availability and accessibility should be considered simultaneously and be referred to as “Spatial Accessibility” (SA). SA takes into account the number of services an individual can select from (availability) and the travel impedance (accessibility) between an individual and locations of service.