Determination of gaps in the spatial accessibility of nursing services for persons over the age of 65 with lowered self-sufficiency: Evidence from the Czech Republic.

Abstract

The subject of this research is one of the main preconditions for the provision of high-quality social care services for people over the age of 65 with lowered self-sufficiency. It involves the spatial accessibility of formally established nursing services examined in 76 districts of the Czech Republic. The aim of this article is to identify and evaluate the gaps in spatial accessibility of the selected residential and outpatient-clinic services at the level of districts in individual regions of the Czech Republic in 2018. A three-phase analysis was performed, including an ArcGIS network analysis, multi-criteria evaluation according to the TOPSIS method, and a correlation analysis encompassing the confidence interval gained via the Bootstrap method. Seven indicators were selected—recipients of the allowance for the care, capacity of residential and outpatient-clinic services, and four indicators of accessibility via individual and public transport within the set time intervals. The results show good availability of residential care (no gap) within 30 min. by individual and public transport in most districts (94%). However, day services centers do not have a space gap in only 28% of districts by individual transport, and 8% of districts by public transport. In the case of day care centers, 54% of districts by individual transport, and 29% of districts by public transport do not have a space gap. The results also show that the level of spatial availability of care (gaps) in the district is not related to the number of people aged 65+ with reduced self-sufficiency in the district. On the contrary, the correlation analysis shows that with the growing number of people aged 65+ with reduced self-sufficiency in the district, the capacity of residential and outpatient services increases and the gaps in spatial accessibility do not decrease.