Abstract
BackgroundThe location of General Practitioner (GP) facilities is an important aspect in the design of healthcare systems to ensure they are accessible by populations with healthcare needs. A key consideration in the facility location decision involves matching the population need for the services with the supply of healthcare resources. The literature points to several factors which may be important in the decision making process, such as deprivation, transportation, rurality, and population age.MethodsThis study uses two approaches to examine the factors associated with GP accessibility in Northern Ireland. The first uses multinomial regression to examine the factors associated with GP coverage, measured as the proportion of people who live within 1.5 km road network distance from the nearest GP practice. The second focuses on the factors associated with the average travel distance to the nearest GP practice, again measured using network distance. The empirical research is carried out using population and geospatial data from Northern Ireland, across 890 Super Output Areas and 343 GP practices.ResultsIn 19% of Super Output Areas, all of the population live within 1.5 km of a GP practice, whilst in 24% none of the population live within 1.5 km. The regression results show that there are higher levels of population coverage in more deprived areas, smaller areas, and areas that have more elderly populations. Similarly, the average travel distance is related to deprivation, population age, and area size.ConclusionsThe results indicate that GP practices are located in areas with higher levels of service need, but also that care needs to be taken to ensure rural populations have sufficient access to services, whether delivered through GP practices or through alternative services where GP practices are less accessible. The methodology and results should be considered by policy makers and healthcare managers when making decisions about GP facility location and service provision.
Highlights
The location of General Practitioner (GP) facilities is an important aspect in the design of healthcare systems to ensure they are accessible by populations with healthcare needs
The population aged 0–15 was only significant in the full coverage models presented previously, significant positive relationships were found in all sensitivity models at the high coverage level, and at the low coverage level in the two models based on a distance of 1.25 km
Health deprivation and Multiple deprivation measure (MDM) were found to be significant in the 0.75 km and 1 km models, but MDM was not significant in the model based on 1 km distance when considering full coverage
Summary
The location of General Practitioner (GP) facilities is an important aspect in the design of healthcare systems to ensure they are accessible by populations with healthcare needs. GP practices must be accessible to facilitate utilisation and better health outcomes [4,5,6,7], highlighting the importance of considering accessibility in the design and management of healthcare systems. Facility location is important in maximising cost and utilisation efficiencies in the healthcare system [9], which is crucial in a climate of public funding constraints and for the business efficiency of GP practices. This study focuses on the location of GP practices, which are crucial components of the healthcare system in providing both primary care and functioning as an access point to other parts of the healthcare system. GP’s provide a range of other services such as vaccinations and smoking
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