Abstract
ABSTRACT The designation of peripheral areas with poor access to health care services is a key criterion for possible support from various targeted programmes or strategies. The proper delineation of the periphery relies on many factors, including (1) the accessibility measure adopted (proximity approach, population percentage, cumulative accessibility, potential accessibility and accessibility measure with competition); (2) the type of medical service (pharmacies, basic health care facilities, emergency health care services, hospitals and specialized health care services); (3) the method of determining the periphery area (fixed threshold vs worst deciles). We conclude that methodological assumptions concerning types of medical services, measures of accessibility or the way of determining the periphery should be precisely identified and tailored to a particular policy and case-study area, as even small differences may have a decisive impact on identification of municipalities belonging to a health care desert. Therefore, planners and decision makers should take note of this fact when evaluating funds both for improving accessibility through transport investments as well as for deciding the location of new health care facilities.
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