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Abstract
Spatial accessibility to health services is a key factor in terms of public health. Even though some tools are available, establishing accessibility criteria applicable from one geographic scale to another remains difficult. Therefore, we propose a method for creating a health accessibility index applicable on a large geographic scale, based on a methodology that overcomes the limitations of political-administrative divisions and which allows a multi-scalar approach to be implemented. The index highlights, on a national scale, areas of cumulative health disadvantages. This index of accessibility to health care combines accessibility and availability and can be adapted to many geographical scales. As accessibility can be understood in various dimensions, a score could be calculated for various fields such as education and culture. The index can help policymakers to identify under-endowed areas and find optimal locations. In terms of public health, it may be used to understand the mechanisms underlying geographic health disparities.
Highlights
The spatial accessibility to health services is a key factor in terms of public health
We propose a method for creating a health accessibility index, named the SCALe (Spatial aCcessibility multiscALar) index, based on distance and not on medical density on a large geographic scale that could be adapted to smaller ones
We propose an index of accessibility in health care that is on a detailed geographic scale but is adaptable to many geographical scales
Summary
The spatial accessibility to health services is a key factor in terms of public health. Its assessment is based on different concepts and measures, the distance to a health professional, the nearest hospital or the closest reference treatment centre being some of the most frequently used. The greater the distance, the lower the access to a health facility. It has been found that patients diagnosed with cancer and living far from a reference care centre are less likely to receive certain types of treatment and have lower chances of survival [1,2,3]. The implementation of a public health policy requires the use of specific tools on a national scale. While various tools exist to assess geographic units such as regions, inter-area comparisons are either difficult or impossible to make, so designing a relevant national public health policy is very challenging. The same applies to research fields where comparisons between studies involves the use of the same measurement tool
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