Abstract
The aim of this paper is to compare several methods for measuring geographical accessibility to community pharmacies in the Lisbon Metropolitan Area (LMA). Twelve measures of pedestrian distance between spatial units and the closest community pharmacy were computed based on the combination of 4 parameters: type of distance, location, centroid definition, and level of spatial unit. For this, the Google Maps Application Programming Interface was used for calculating network pedestrian distances, using a list of 801 community pharmacies and population data from the Census 2011. Correlations between every method were performed, and the variations of the estimated number of inhabitants served at an 800-m distance were analyzed. Local errors were assessed comparing every combination to the most accurate one. The results show that the number of people served ranges from 70 to 89% of the total population, depending upon the method used. The use of pedestrian network distances decreases by more than 10 points the population coverage, compared to crow-fly distances. The finest parameters of population assignment are more inclusive than coarser ones. This research demonstrates the influence of several measurement methods on coverage estimations. Empirical evidence indicates that both measurement and policies should be called into question in order to improve actual coverage.
Highlights
With the rise of equity issues, accessibility to healthcare services has been under growing scrutiny (Gulliford and Morgan 2013)
The main aim of this study is to investigate the differences between several ways to measure geographical accessibility, based on the four parameters aforementioned, and to determine which one is best suited for pedestrian access measurement
Methods based on Euclidean distances have proven much more error-prone, with very high numbers of people mistakenly included within a given distance from a pharmacy
Summary
With the rise of equity issues, accessibility to healthcare services has been under growing scrutiny (Gulliford and Morgan 2013). Among many definitions including the affordability and availability dimensions (Penchansky and Thomas 1981; Gulliford et al 2002), geographical accessibility is referred to as the ease with which an individual can reach a given destination (Jones 1981). It is a measure of potential access. Geographical accessibility can be threatened by many factors related to local barriers and poor local environment, physical impairment, cultural and linguistic difficulties, scarce financial resources and the lack of social capital (Ensor and Cooper 2004). Concerns about the most efficient and inclusive location of and access to healthcare have arisen, necessitating the development of accurate measurement methods (Guagliardo 2004; Bell et al 2013)
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