Abstract
Abstract Background The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy. This work 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. Methods This 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 Enhanced Two-Step Floating Catchment Area (E2FCA) algorithm. 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. Results We 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. Conclusions ISA 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. Key messages Indicator of healthcare access at fine spatial scale allows us to identify precisely critical areas where healthcare professionals need to be allocated. ISA is a multidimensional measure, which combines the volume of services relative to population size with the proximity of services relative to the population’s location.
Highlights
The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy
This means that within less than 15 min’ travel time, access to a gynecologist is maximal for the entire population living in these L'Îlot Regroupé pour des Indicateurs Statistiques (IRIS)
Access to a gynecologist decreases in proportion to the decay function for the population living in the IRIS at a travel time of between 15 and 34 min
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
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