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Validation and reliability study of the Turkish version of the health services access scale

Year 2024, Volume: 22 Issue: 3, 289 - 304
https://doi.org/10.20518/tjph.1519852

Abstract

Objective: The aim of this study is to establish the Turkish validity and reliability of the Healthcare Access Scale and to determine whether perceptions of healthcare access vary according to demographic variables.

Methods: Data for the research were collected through surveys of 468 participants across Türkiye. Exploratory factor analysis and confirmatory factor analysis were conducted in the process of adapting the Healthcare Access Scale. In addition, t-tests and ANOVA tests were used to determine variations in access to healthcare according to demographic variables. The factors obtained from the exploratory factor analysis were confirmed by confirmatory factor analysis. The fit index values of the five-dimension health care access scale were found to be in the good fit range.

Results: As a result of the exploratory factor analysis, a five-dimensional structure was obtained, explaining 69.625% of the total variance. In the confirmatory factor analysis, the model’s fit indices (CMIN/DF = 2.148, RMR = 0.049, GFI = 0.949, IFI = 0.969, TLI = 0.961, CFI = 0.969, NFI = 0.944, AGFI = 0.926, RMSEA = 0.050) were found to be satisfactory. Reliability analysis indicated a Cronbach’s alpha coefficient of 0.919 for the entire scale, with coefficients for the subdimensions ranging from 0.740 to 0.874.

Conclusion: This study makes a significant contribution to the literature by testing the appropriateness, validity and reliability of the Healthcare Access Scale.

References

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  • Jean-Pierra, M., & Ritu S. “Healthy Aging” Concepts and measures. J Am Med Dir Assoc, 2017;18(6):460-464
  • Wendt, C. Changing healthcare system types. Social policy & administration,2014; 48(7): 864-882.
  • Aizhan Z., & Saipinov D. The stages of the healthcare system reform of the Republic of Kazakhstan. Procedia-Social and Behavioral Sciences, 2014; 140: 657-61.
  • Fitzpatrick, F., & Riordan, M. O. Performance management of Clostridium difficile infection in hospitals–the carrot or stick approach?. Anaerobe, 2016; 37: 8-12.
  • Buerhaus, P.I., Desroches, C., Applebaum, S., Hess, R., Norman, L.D., Donelan, K. Are nurses ready for healthcare reform? A decade of survey research. Nurs Economics, 2012; 30(6): 318-330.
  • Arah, O.A., Klazinga, N.S., Delnoij, D.M., Asbroek, A.T., Custers, T. Conceptual frameworks for health systems perfor-mance: A quest for effectiveness, quality, and improvement. Int J Qual Health Care,2003; 15(5): 377–98.
  • Wagstaff. A., & van Doorslaer, E. Protecting households from catastrophic spending. J Hum Resour,2000; 35(4):716-33.
  • Xu, K., Evans, D. B., Carrin, G., Aguilar-Rivera, A. M., Musgrove, P., & Evans, T. Protecting households from catastrophic health spending. Health affairs, 2007; 26(4), 972-983.
  • Russell, K. C. Two years later: A qualitative assessment of youth well-being and the role of aftercare in outdoor behavioral healthcare treatment. In Child and Youth Care Forum. Kluwer Academic Publishers-Human Sciences Press. 2005; 34: 209-239. https://link.springer.com/content/pdf/10.1007/s10566-005-3470-7.pdf.
  • Xu, K., Evans, D. B., Kawabata, K., Zeramdini, R., Klavus, J., & Murray, C. J. Household catastrophic health expenditure: a multicountry analysis. The lancet, 2003; 362(9378): 111-117.
  • Culyer, A.J., Newhouse, J.P.,& eds. Handbook of health economics. Elsevier.2000.
  • Patil, S., & Pardeshi, S. Health monitoring system using IoT. Int Res J Eng Technol (IRJET), 2018; 5(4):1678-82.
  • Guagliardo, M.F., Jablonski, K.A., Joseph, J.G. et al. Do pediatric hospitalizations have a unique geography?. BMC Health Serv Res 2004; 4, (2): 1-9.
  • Bowers, M. R., Swan, J. E., & Koehler, W. F. What attributes determine quality and satisfaction with health care delivery?. Health Care Management Review, 1994; 19(4):49-55
  • Penchansky, R., & Thomas, J.W.The concept of access: definition and relationship to consumer satisfaction. Med Care, 1981; 19(2):127-40.
  • Norredam, M.L., Nielsen, A.S., & Krasnik, A. Migrants’ access to healthcare. Dan Med Bull, 2007; 54(1):48-9.
  • Sosyal Güvenlik Kurumu. Genel Sağlık Sigortası. Ankara: Sosyal Güvenlik Kurumu 2013.
  • Hunter, K.A., & Thomson, B.A. Scoping review of social determinants of health curricula in post-graduate medical educa-tion. Can Med Educ, 2019; 10(3):61-71. PMC6681926.
  • Johnson, K. F.Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH). BMC Health Services Research, 2023; 23(1), 374.Sachs, J. D. Achieving universal health coverage in low-income settings. The Lancet, 2012; 380(9845), 944-947.
  • Begley, C.E., Lairson, D., Morgan, R.O., Rowan, P.J., & Balkrishnan, R. Evaluating the healthcare system: Effectiveness, efficiency, and equity. Chicago: Health Administration Press.2013.
  • Levesque, J.F., Harris, M.F.,& Russell G. Patient-centred access to health care: Conceptualizing access at the interface of health systems and populations. Int J Equity Health,2013; 12:1-9. http://www.equityhealthj.com/content/12/1/18
  • Roberton, T., Carter, E.D., Chou, V.B., Stegmuller, A.R., Jackson, B.D., Tam, Y.,& et al. (2020). Early estimates of the indi-rect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health,2020; 8(7): 901-908
  • Brems, C., Johnson, M.E., Warner, T.D., Roberts, L.W. Barriers to healthcare as reported by rural and urban interprofes-sional providers. J Interprof Care, 2006; 20(2):105-18.
  • Bali, A.S., & Ramesh, M. (2023). Knowledge–practice gap in healthcare payments: The role of policy capacity. Policy Soc, 2023; 42(3): 406–18.
  • Bali A.S., Capano. G., & Ramesh, M. Anticipating and designing for policy effectiveness. Policy Soc, 2019; 38(1): 1–13.
  • Tatar, M., Mollahaliloğlu, S., Şahin, B., Aydın, S., Maress, A., & Hernandez-Quevedo, C.Türkiye health system review. Health Systems in Transition, 2011; 13(6), 1-186.
  • Diğer, H., & Bilgin, R.(2021). OECD ülkelerinde sağlık sistemlerinin sağlık göstergeleri açısından değerlendirilmesi. 1. Uluslararası Sosyal Bilimlerde Yenilikçi Yaklaşımlar Dergisi, 5(4),212-35.
  • Seçtim, H. Sağlıkta dönüşüm programı üzerine bir değerlendirme. Manag Polit Sci Rev, 2019; 1(1), 117-33.
  • Mendelson, D.N., & Schwartz, W.B. The effects of aging and population growth on health care costs. Health Aff, 1993; 12(1),119-25
  • OECD. OECD. Stat. Published 2023. Accessed February 13, 2024. https://stats.oecd.org/
  • Türkiye İstatistik Kurumu (TÜİK). Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2022. Erişim: 27 Aralık 2023. https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayalı-Nüfus-Kayıt-Sistemi-Sonuçları-2022-49685&dil.
  • Tabachnick, B.G., & Fidell, L.S. Using multivariate statistics. Allyn & Bacon.2001.
  • Byrne B.M. Structural equation modeling with AMOS: Basic concepts, applications, and programming. 2nd ed. Routledge Academy.2010
  • Williams, L.J.,& Abdi, H. Fisher’s least significant difference (LSD) test. Encycl Res Des, 2010; 218(4): 840-53.
  • Santoyo-Sánchez G, Reyes-Morales H, Flores-Hernández S, Pelcastre-Villafuerte BE, Merino-Soto C. Psychometric prop-erties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale. Eval Health Prof. 2023;46:159-69.
  • Tanner EC, Vann RJ, Kizilova EG. Consumer-level perceived access to health services and its effects on vulnerability and health outcomes. J Public Policy Mark. 2020;39:240-55.
  • Filiz M, Karagöz Y, Karaşin Y. Sağlık hizmetlerine erişimin seçmen davranışı üzerine etkisinin belirlenmesi: Bir ölçek geliştirme çalışması. Iğdır Univ J Soc Sci. 2023;(34):472-86.
  • Zandam H, Juni MH, Hayati KS, Anisah B. Development and validation of perceived access to health care measurement instrument. Int J Public Health Clin Sci. 2017;4:158-71
Year 2024, Volume: 22 Issue: 3, 289 - 304
https://doi.org/10.20518/tjph.1519852

Abstract

References

  • Nunes R., Nunes S.B., &Rego G. Health care as a universal right. Z Gesundh Wiss .2017;25(1):1-9.
  • Jean-Pierra, M., & Ritu S. “Healthy Aging” Concepts and measures. J Am Med Dir Assoc, 2017;18(6):460-464
  • Wendt, C. Changing healthcare system types. Social policy & administration,2014; 48(7): 864-882.
  • Aizhan Z., & Saipinov D. The stages of the healthcare system reform of the Republic of Kazakhstan. Procedia-Social and Behavioral Sciences, 2014; 140: 657-61.
  • Fitzpatrick, F., & Riordan, M. O. Performance management of Clostridium difficile infection in hospitals–the carrot or stick approach?. Anaerobe, 2016; 37: 8-12.
  • Buerhaus, P.I., Desroches, C., Applebaum, S., Hess, R., Norman, L.D., Donelan, K. Are nurses ready for healthcare reform? A decade of survey research. Nurs Economics, 2012; 30(6): 318-330.
  • Arah, O.A., Klazinga, N.S., Delnoij, D.M., Asbroek, A.T., Custers, T. Conceptual frameworks for health systems perfor-mance: A quest for effectiveness, quality, and improvement. Int J Qual Health Care,2003; 15(5): 377–98.
  • Wagstaff. A., & van Doorslaer, E. Protecting households from catastrophic spending. J Hum Resour,2000; 35(4):716-33.
  • Xu, K., Evans, D. B., Carrin, G., Aguilar-Rivera, A. M., Musgrove, P., & Evans, T. Protecting households from catastrophic health spending. Health affairs, 2007; 26(4), 972-983.
  • Russell, K. C. Two years later: A qualitative assessment of youth well-being and the role of aftercare in outdoor behavioral healthcare treatment. In Child and Youth Care Forum. Kluwer Academic Publishers-Human Sciences Press. 2005; 34: 209-239. https://link.springer.com/content/pdf/10.1007/s10566-005-3470-7.pdf.
  • Xu, K., Evans, D. B., Kawabata, K., Zeramdini, R., Klavus, J., & Murray, C. J. Household catastrophic health expenditure: a multicountry analysis. The lancet, 2003; 362(9378): 111-117.
  • Culyer, A.J., Newhouse, J.P.,& eds. Handbook of health economics. Elsevier.2000.
  • Patil, S., & Pardeshi, S. Health monitoring system using IoT. Int Res J Eng Technol (IRJET), 2018; 5(4):1678-82.
  • Guagliardo, M.F., Jablonski, K.A., Joseph, J.G. et al. Do pediatric hospitalizations have a unique geography?. BMC Health Serv Res 2004; 4, (2): 1-9.
  • Bowers, M. R., Swan, J. E., & Koehler, W. F. What attributes determine quality and satisfaction with health care delivery?. Health Care Management Review, 1994; 19(4):49-55
  • Penchansky, R., & Thomas, J.W.The concept of access: definition and relationship to consumer satisfaction. Med Care, 1981; 19(2):127-40.
  • Norredam, M.L., Nielsen, A.S., & Krasnik, A. Migrants’ access to healthcare. Dan Med Bull, 2007; 54(1):48-9.
  • Sosyal Güvenlik Kurumu. Genel Sağlık Sigortası. Ankara: Sosyal Güvenlik Kurumu 2013.
  • Hunter, K.A., & Thomson, B.A. Scoping review of social determinants of health curricula in post-graduate medical educa-tion. Can Med Educ, 2019; 10(3):61-71. PMC6681926.
  • Johnson, K. F.Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH). BMC Health Services Research, 2023; 23(1), 374.Sachs, J. D. Achieving universal health coverage in low-income settings. The Lancet, 2012; 380(9845), 944-947.
  • Begley, C.E., Lairson, D., Morgan, R.O., Rowan, P.J., & Balkrishnan, R. Evaluating the healthcare system: Effectiveness, efficiency, and equity. Chicago: Health Administration Press.2013.
  • Levesque, J.F., Harris, M.F.,& Russell G. Patient-centred access to health care: Conceptualizing access at the interface of health systems and populations. Int J Equity Health,2013; 12:1-9. http://www.equityhealthj.com/content/12/1/18
  • Roberton, T., Carter, E.D., Chou, V.B., Stegmuller, A.R., Jackson, B.D., Tam, Y.,& et al. (2020). Early estimates of the indi-rect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health,2020; 8(7): 901-908
  • Brems, C., Johnson, M.E., Warner, T.D., Roberts, L.W. Barriers to healthcare as reported by rural and urban interprofes-sional providers. J Interprof Care, 2006; 20(2):105-18.
  • Bali, A.S., & Ramesh, M. (2023). Knowledge–practice gap in healthcare payments: The role of policy capacity. Policy Soc, 2023; 42(3): 406–18.
  • Bali A.S., Capano. G., & Ramesh, M. Anticipating and designing for policy effectiveness. Policy Soc, 2019; 38(1): 1–13.
  • Tatar, M., Mollahaliloğlu, S., Şahin, B., Aydın, S., Maress, A., & Hernandez-Quevedo, C.Türkiye health system review. Health Systems in Transition, 2011; 13(6), 1-186.
  • Diğer, H., & Bilgin, R.(2021). OECD ülkelerinde sağlık sistemlerinin sağlık göstergeleri açısından değerlendirilmesi. 1. Uluslararası Sosyal Bilimlerde Yenilikçi Yaklaşımlar Dergisi, 5(4),212-35.
  • Seçtim, H. Sağlıkta dönüşüm programı üzerine bir değerlendirme. Manag Polit Sci Rev, 2019; 1(1), 117-33.
  • Mendelson, D.N., & Schwartz, W.B. The effects of aging and population growth on health care costs. Health Aff, 1993; 12(1),119-25
  • OECD. OECD. Stat. Published 2023. Accessed February 13, 2024. https://stats.oecd.org/
  • Türkiye İstatistik Kurumu (TÜİK). Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2022. Erişim: 27 Aralık 2023. https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayalı-Nüfus-Kayıt-Sistemi-Sonuçları-2022-49685&dil.
  • Tabachnick, B.G., & Fidell, L.S. Using multivariate statistics. Allyn & Bacon.2001.
  • Byrne B.M. Structural equation modeling with AMOS: Basic concepts, applications, and programming. 2nd ed. Routledge Academy.2010
  • Williams, L.J.,& Abdi, H. Fisher’s least significant difference (LSD) test. Encycl Res Des, 2010; 218(4): 840-53.
  • Santoyo-Sánchez G, Reyes-Morales H, Flores-Hernández S, Pelcastre-Villafuerte BE, Merino-Soto C. Psychometric prop-erties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale. Eval Health Prof. 2023;46:159-69.
  • Tanner EC, Vann RJ, Kizilova EG. Consumer-level perceived access to health services and its effects on vulnerability and health outcomes. J Public Policy Mark. 2020;39:240-55.
  • Filiz M, Karagöz Y, Karaşin Y. Sağlık hizmetlerine erişimin seçmen davranışı üzerine etkisinin belirlenmesi: Bir ölçek geliştirme çalışması. Iğdır Univ J Soc Sci. 2023;(34):472-86.
  • Zandam H, Juni MH, Hayati KS, Anisah B. Development and validation of perceived access to health care measurement instrument. Int J Public Health Clin Sci. 2017;4:158-71
There are 39 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Original Research
Authors

Mustafa Filiz 0000-0002-7445-5361

Nurgül Erdal 0000-0002-2961-3906

Olkan Budak 0000-0002-2276-2300

Early Pub Date December 8, 2024
Publication Date
Submission Date July 21, 2024
Acceptance Date November 8, 2024
Published in Issue Year 2024 Volume: 22 Issue: 3

Cite

APA Filiz, M., Erdal, N., & Budak, O. (2024). Validation and reliability study of the Turkish version of the health services access scale. Turkish Journal of Public Health, 22(3), 289-304. https://doi.org/10.20518/tjph.1519852
AMA Filiz M, Erdal N, Budak O. Validation and reliability study of the Turkish version of the health services access scale. TJPH. December 2024;22(3):289-304. doi:10.20518/tjph.1519852
Chicago Filiz, Mustafa, Nurgül Erdal, and Olkan Budak. “Validation and Reliability Study of the Turkish Version of the Health Services Access Scale”. Turkish Journal of Public Health 22, no. 3 (December 2024): 289-304. https://doi.org/10.20518/tjph.1519852.
EndNote Filiz M, Erdal N, Budak O (December 1, 2024) Validation and reliability study of the Turkish version of the health services access scale. Turkish Journal of Public Health 22 3 289–304.
IEEE M. Filiz, N. Erdal, and O. Budak, “Validation and reliability study of the Turkish version of the health services access scale”, TJPH, vol. 22, no. 3, pp. 289–304, 2024, doi: 10.20518/tjph.1519852.
ISNAD Filiz, Mustafa et al. “Validation and Reliability Study of the Turkish Version of the Health Services Access Scale”. Turkish Journal of Public Health 22/3 (December 2024), 289-304. https://doi.org/10.20518/tjph.1519852.
JAMA Filiz M, Erdal N, Budak O. Validation and reliability study of the Turkish version of the health services access scale. TJPH. 2024;22:289–304.
MLA Filiz, Mustafa et al. “Validation and Reliability Study of the Turkish Version of the Health Services Access Scale”. Turkish Journal of Public Health, vol. 22, no. 3, 2024, pp. 289-04, doi:10.20518/tjph.1519852.
Vancouver Filiz M, Erdal N, Budak O. Validation and reliability study of the Turkish version of the health services access scale. TJPH. 2024;22(3):289-304.

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