Abstract
Providing the entire population with the same accessibility to services of general interest is among the priorities of EU policy. Among these services, those concerned with medical treatment occupy a special place due to their social and economic importance. The study raises the issue of modelling the population's spatial accessibility to medical services in the NorthEastern Region of Romania. A trans-scalar methodology that has been tailored to the specic features of the Romanian medical system was employed for computing indexes of accessibility. The methodology brings together into one synthetic indicator ve hierarchical levels of analysis, the geographical proximity of service centres, their degree of attractiveness and the potential need for medical services at local level. The results highlight areas with different levels of accessibility to medical services and their dysfunctionalities according to each variable employed in the analysis.
Highlights
Access to health services is a binary variable that can take two values: 1 if the population can from a theoretical point of view access the service concerned, and 0 if it is impossible for them to do so
Since the Romanian Government is legally bound to ensure that the entire population has access to health services, irrespective of the environment and place where they live, it could be considered that the inhabitants of any town or village in the North-East Region can
The population's spatial accessibility to medical services will be evaluated in a multi-scalar approach, in terms of a ve-level hierarchy, due account being taken of the degree of complexity of the centres involved in providing the North-East Region with medical coverage, the nature of the road communication network and the geographical location and characteristics of population nuclei
Summary
Access to health services is a binary variable that can take two values: 1 if the population can from a theoretical point of view access the service concerned, and 0 if it is impossible for them to do so. The quality and quantity of the services on offer is affected by the anisotropic characteristics of the area concerned, and by the ability of the population to take advantage of them. The latter depends, inter alia, on their degree of basic health awareness, the nancial resources of each household and the distance between residences and health service providers. The population's spatial accessibility to medical services will be evaluated in a multi-scalar approach, in terms of a ve-level hierarchy, due account being taken of the degree of complexity of the centres involved in providing the North-East Region with medical coverage, the nature of the road communication network and the geographical location and characteristics of population nuclei. Worth mentioning that in 2011 hospitals in Romania were reclassi ed by Ministerial Order in one of ve categories depending on their level of competence (Ministry of Health, 2011b): category 5 hospitals – with a limited level of competence (provision for the care of the chronically ill, single-specialty provision, or palliative care); category 4 hospitals – with a basic level of competence (serving the population of a limited area and capable of treating non-complex medical conditions); category 3 hospitals – with a medium level of competence (normally serving the population of their own county and capable of treating medical conditions with a moderate level of complexity); category 2 hospitals – with a high level of competence (serving the population of their own county and that of neighbouring counties and capable of treating medical conditions with a high level of complexity) and category 1 hospitals – with a very high level of competence (providing medical care at regional level and treating extremely complex conditions)
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