Developing a contextually relevant framework for assessing older adults’ access to primary healthcare in Iran: an expert-based qualitative study

BACKGROUND & AIM: Given the increasing elderly population in Iran, addressing older adults' access to healthcare services is essential. This study aimed to develop a contextually relevant framework for assessing older adults' access to primary healthcare in Iran. METHODS: This study utilized a conventional qualitative content analysis approach through focus group discussions with experts in elderly care. Participants were selected using purposive sampling with maximum diversity. Data were collected through a checklist developed based on the Levesque framework, and the collected and transcribed data were analyzed using content analysis. FINDINGS: The main dimensions of older adults' access to health center services were categorized into two core domains aligned with the Levesque framework: health system characteristics (supply-side) and population capabilities (demand-side)>>. The health system dimension was further subcategorized into < < availability, acceptability, accommodation, affordability, and appropriateness>>. The demographic context of accessibility was categorized into subcategories of < < the ability to perceive, seek, reach, pay for, and engage with healthcare services>>. Based on feedback from subject-matter experts, appropriate components were proposed for a detailed examination of each subcategory, and a final consensus was reached. CONCLUSION: The contextually relevant framework derived from this study can help identify reasons for older adults' reluctance or inability to access elderly care services at health centers. Future studies can apply the proposed framework to thoroughly examine the challenges of implementing the national aging care program across various universities of medical sciences in Iran.