Abstract
Access to health care is a sensitive issue in low population density territories, as these areas tend to have a lower level of service provision. One dimension of access is accessibility. This paper focuses on measuring the accessibility to urgent and emergency care services in the Portuguese region of Baixo Alentejo, a territory characterized by low population density. Data for the calculation of accessibility is the road network, and the methodology considers the application of a two-level network analyst method: time-distance by own mean (car or taxi) to the urgent care services and the time distance to emergency services as a way to get assistance and to go to urgent care services. While urgent care accessibility meets the requirements stipulated in the Integrated Medical Emergency System's current legislative framework, the simulation of different scenarios of potential accessibility shows intra-regional disparities. Some territories have a low level of accessibility. Older adults, the poorly educated, and low-income population, also have the lowest levels of accessibility, which translates into dually disadvantageous situation since the potential users of emergency services are most likely to belong to this group of citizens.
Highlights
In the last decades, demographic and economic trends have favored urbanized territories in detriment of rural areas, primarily characterized by the lowest population densities, demographic decline, and a large share of older adults with limited mobility and low income
This paper aims to measure the accessibility of emergency services and medical emergency facilities in the Portuguese region of Baixo Alentejo, a territory characterized by low population density and weak economic activity
Considering the analysis by age structure, we find that the elderly population has a lower accessibility rate (Table 1)
Summary
Demographic and economic trends have favored urbanized territories in detriment of rural areas, primarily characterized by the lowest population densities, demographic decline, and a large share of older adults with limited mobility and low income. The access to health services in these territories becomes more relevant, as the decline of demand induced a growing scarcity of health services, especially the urgent and emergency care services. In this context, the studies related to equity in access gains importance in support of policy recommendations. The concept of access to health care is a complex process, and for that reason, there are different perspectives on its definition or methods to be used. Some authors use the term “accessibility”, while others prefer the term “access”. Both refer to the way of obtaining health care services[1,2]
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