Inequalities in access to hospitals: a case study in the Islamic Republic of Iran 1997-2012.

Abstract

Nowadays, the significance of applying Geographic information system (GIS) to survey accessibility to hospitals and understanding disparities in this regard has increased. The main aim of this descriptive-analytical research was to study the spatial accessibility of the population of Kermanshah for 3 years 1997 (n=693157), 2007 (n=794863), and 2012 (n=851 405) to hospitals based on age and gender groups through GIS. The study was conducted based on network analysis models, mean centre, and standard distance in the environment of Arc/GIS. A standard radius of 1500 metres was set for the medical centres, and a 25-minute walking span was set for the distance of each person from home to the nearest hospital. The results of the network analysis demonstrated that the hospitals were inaccessible to the populations according to our criteria, and their geographical access to hospitals measured 68.80%, 64.23% and 66.20% in 1997, 2007, and 2012, respectively. Women aged 65 years and above were more at risk in this regard. Over the total period under study, the results revealed that hospitals were concentrated in the central and southern areas of Kermanshah.