Abstract：
BACKGROUND: Dominant conceptualisations of access to healthcare are limited, framed in terms of speed and supply. The Candidacy Framework offers a more comprehensive approach, identifying diverse influences on how access is accomplished.
OBJECTIVE: We aimed to characterise how the Candidacy Framework can explain access to general practice - an increasingly fraught area of public debate and policy.
METHODS: Qualitative review guided by the principles of critical interpretive synthesis.
METHODS: We conducted a literature review using an \"author-led\" approach, involving iterative analytically-guided searches. Papers were eligible for inclusion if they related to the context of general practice, without geographical or time limitations. Key themes relating to access to general practice were extracted and synthesised using the Candidacy Framework.
RESULTS: 229 papers were included in the final synthesis. Each of the seven features identified in the original Candidacy Framework is highly salient to general practice. Using the lens of candidacy demonstrates that access to general practice is subject to multiple influences that are highly dynamic, contingent and subject to constant negotiation. These influences are socio-economically and institutionally patterned, creating risks to access for some groups. This analysis enables understanding of the barriers to access that may exist even though general practice in the UK is free at the point of care, but also demonstrates that a Candidacy Framework specific to this setting is needed.
CONCLUSIONS: The Candidacy Framework has considerable value as a way of understanding access to general practice, offering new insights for policy and practice. The original framework would benefit from further customisation for the distinctive setting of general practice.
OBJECTIVE: We aimed to characterise how the Candidacy Framework can explain access to general practice - an increasingly fraught area of public debate and policy.
METHODS: Qualitative review guided by the principles of critical interpretive synthesis.
METHODS: We conducted a literature review using an \"author-led\" approach, involving iterative analytically-guided searches. Papers were eligible for inclusion if they related to the context of general practice, without geographical or time limitations. Key themes relating to access to general practice were extracted and synthesised using the Candidacy Framework.
RESULTS: 229 papers were included in the final synthesis. Each of the seven features identified in the original Candidacy Framework is highly salient to general practice. Using the lens of candidacy demonstrates that access to general practice is subject to multiple influences that are highly dynamic, contingent and subject to constant negotiation. These influences are socio-economically and institutionally patterned, creating risks to access for some groups. This analysis enables understanding of the barriers to access that may exist even though general practice in the UK is free at the point of care, but also demonstrates that a Candidacy Framework specific to this setting is needed.
CONCLUSIONS: The Candidacy Framework has considerable value as a way of understanding access to general practice, offering new insights for policy and practice. The original framework would benefit from further customisation for the distinctive setting of general practice.
摘要：
背景：获得医疗保健的主要概念化是有限的，框架在速度和供应方面。候选人框架提供了一个更全面的方法，识别对访问方式的不同影响。
目的：我们的目的是描述候选人资格框架如何解释一般实践的获取-公众辩论和政策中日益充满争议的领域。
方法：以批判性解释性综合原则为指导的定性审查。
方法：我们使用“作者主导”的方法进行了文献综述，涉及迭代分析引导搜索。如果论文与一般实践的背景有关，则有资格被纳入，没有地理或时间限制。使用候选人资格框架提取和综合了与一般实践有关的关键主题。
结果：229篇论文被纳入最终合成。原始候选人框架中确定的七个特征中的每个特征对于一般实践都非常重要。使用候选人资格的镜头表明，获得一般实践受到高度动态的多种影响，临时的，需要不断的谈判。这些影响是社会经济和制度模式，给某些群体的访问带来风险。这种分析使人们能够理解可能存在的访问障碍，即使英国的一般做法在护理点是免费的，但也表明需要一个特定于此设置的候选人框架。
结论：候选人资格框架作为理解一般实践的一种方式具有相当大的价值，为政策和实践提供新的见解。原始框架将受益于针对一般实践的独特设置的进一步定制。
目的：我们的目的是描述候选人资格框架如何解释一般实践的获取-公众辩论和政策中日益充满争议的领域。
方法：以批判性解释性综合原则为指导的定性审查。
方法：我们使用“作者主导”的方法进行了文献综述，涉及迭代分析引导搜索。如果论文与一般实践的背景有关，则有资格被纳入，没有地理或时间限制。使用候选人资格框架提取和综合了与一般实践有关的关键主题。
结果：229篇论文被纳入最终合成。原始候选人框架中确定的七个特征中的每个特征对于一般实践都非常重要。使用候选人资格的镜头表明，获得一般实践受到高度动态的多种影响，临时的，需要不断的谈判。这些影响是社会经济和制度模式，给某些群体的访问带来风险。这种分析使人们能够理解可能存在的访问障碍，即使英国的一般做法在护理点是免费的，但也表明需要一个特定于此设置的候选人框架。
结论：候选人资格框架作为理解一般实践的一种方式具有相当大的价值，为政策和实践提供新的见解。原始框架将受益于针对一般实践的独特设置的进一步定制。
