Mapping the application of Levesque et al.’s access framework in health research: A protocol for a scoping review

Background: Access to healthcare remains a global concern in health systems research and policy, playing a pivotal role in shaping population health outcomes and advancing health equity efforts. Levesque et al.’s (2013) conceptual framework for healthcare access (“Levesque’s framework”) has achieved prominence as a comprehensive, multidimensional model that integrates both supply-side and demand-side determinants through five dimensions of access and corresponding population abilities. However, studies applying Levesque’s framework vary in their conceptual interpretations, with researchers frequently encountering difficulties categorizing responses into specific dimensions, leading to inconsistent application. Objectives: This scoping review aims to examine the foundational concepts related to access, working definitions within Levesque’s framework, summarize study author(s) recommendations with respect to adjustments and extensions to Levesque’s framework, and assess how it has been applied to end-of-life care research to guide future study design. Methods: Following Joanna Briggs Institute best-practice guidance, we will search PubMed, Scopus, Web of Science, CINAHL, and Google Scholar for studies citing Levesque’s et al.’s foundational article. Two reviewers will independently screen studies and extract data using predetermined criteria, compare those extracted results to the results from two AI tools (the most recent versions of ChatGPT and Claude), and analyze findings through frequency counts and basic qualitative content analysis. Expected Results: This review will systematically map how Levesque’s framework has been utilized across health research studies. The analysis will identify patterns and variations in foundational concepts related to access, the working definitions of the five dimensions and abilities of access and explore recommendations for enhancing the framework. For end-of-life care contexts specifically, this review will explore current applications to inform the design of future research studies. Levesque, J.-F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12(1), 18. https://doi.org/10.1186/1475-9276-12-18