Redefining open access to primary care.

The issue of access to health care has become an increasingly complex topic over the past decade. When referring to access in health care, a number of definitions come to mind. Access to care has been discussed in health care literature for decades, generally referring to the availability of health care services or the actual receipt of those services. These discussions have been used in several distinct contexts. A review of the literature reveals several important trends. Initially, access to health care referred to a measure of a defined population’s ability to receive care. Access literature most often focused on the availability of health care services for the underserved. The work of Berk1 and Andersen2 are representative examples of those discussions. Later, the term access began to be used when discussing the comprehensiveness of particular health plans or when referring to the ease with which a capitated population is able to seek and receive care from specialists. The work of Nilson3 and Blecher4 are examples of those studies. Recently, a third reference to health care access has emerged. It refers to insured patients’ ability to seek and receive primary care in a timely manner. Both managed care and fee-for-service organizations have struggled with this issue. While this topic is discussed widely throughout the country, very little has appeared in the literature. This article will focus on this third reference to access. This article will present three main topics: 1. A definition for access excellence.