Abstract
BackgroundThe evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy. Traditional methods - such as Physician Population Ratios (PPR) or shortest travel time - offer only a one-dimensional view of accessibility. This paper developed an improved indicator: the Index of Spatial Accessibility (ISA) to measure geographical healthcare accessibility at the smallest available infra-urban level, that is, the Îlot Regroupé pour des Indicateurs Statistiques.MethodsThis study was carried out in the department of Nord, France. Healthcare professionals are geolocalized using postal addresses available on the French state health insurance website. ISA is derived from an Enhanced Two-Step Floating Catchment Area (E2FCA). We have constructed a catchment for each healthcare provider, by taking into account residential building centroids, car travel time as calculated by Google Maps and the edge effect. Principal Component Analyses (PCA) were used to build a composite ISA to describe the global accessibility of different kinds of health professionals.ResultsWe applied our method to studying geographical healthcare accessibility for pregnant women, by selecting three types of healthcare provider: general practitioners, gynecologists and midwives. A total of 3587 healthcare providers are potentially able to provide care for inhabitants of the department of Nord. On average there are 92 general practitioners, 22 midwives and 21 gynecologists per 100,000 residents. The composite ISA for the three types of healthcare provider is 39 per 100,000 residents. A comparative analysis between ISA and physician-population ratios indicates that ISA represents a more even distribution whereas the physician-population ratios show an ‘all-or-nothing’ approach.ConclusionISA is a multidimensional and improved measure, which combines the volume of services relative to population size with the proximity of services relative to the population’s location, available at the smallest feasible geographical scale. It could guide policy makers towards highlighting critical areas in need of more healthcare providers, and these areas should be earmarked for further knowledge-based policy making.
Highlights
The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy
Access to a gynecologist decreases in proportion to the decay function for the population living in the L'Îlot Regroupé pour des Indicateurs Statistiques (IRIS) at a travel time of between 15 and 34 min
We used the spatial analysis and mapping capabilities of GIS to describe the spatial distribution of Index of Spatial Accessibility (ISA), to identify the critical geographic zones of poor accessibility on an IRIS scale
Summary
The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy. Healthcare access is a multidimensional concept that includes: availability of care, the ability to get to and pay for available care, or to seek and utilize available care It involves financial accessibility, availability, acceptability, and geographical accessibility [7]. The accessibility of health services can be classified into two main categories: potential accessibility (ease of accessing services based on existing conditions) and revealed accessibility (actual use of health care services in a given location). These two types of accessibility have a particular meaning in the French context. This paper will focus on measuring potential spatial accessibility to health care professionals
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
