Potential Spatial Accessibility to Cardiovascular Hospitals in Romania

Abstract

Cardiovascular diseases (CVDs) represent the leading cause of death globally. Romania recorded the highest mortality rate due to CVDs in the EU in 2022, with 162,984 deaths, while the number of registered patients with CVDs surpassed 4 million. This study aims to measure the population’s potential spatial accessibility to cardiovascular hospitals in Romania, as timely access to such healthcare facilities is crucial to minimise avoidable mortality due to CVDs. Although distance is an essential parameter of spatial accessibility, time-based analysis is more reflective of real-world scenarios due to the unpredictability of travel. The potential spatial accessibility was measured using the Application Program Interface (API) offered through the Google Maps platform and a personal car as the transportation mode. The country’s cardiovascular hospital network comprises 161 units, of which 84 can provide complex care. Because all of them are located in urban areas, three different time slots were considered to distinguish between high and low traffic congestion situations. We created hierarchies of ten-minute and five km intervals for travel time and distance, respectively, to emphasize the population percentages with better or low potential spatial accessibility. Results showed that only 15% of the population can reach the nearest cardiovascular hospital in less than 20 min, and 23% must travel for over 60 min, while 45.7% live farther than 20 km from a cardiovascular hospital. Inhabitants living in remote areas, especially rural ones, are the most vulnerable, having to travel for the longest time and distance. Actions like improving the existing transport infrastructure and upgrading healthcare facilities and equipment are needed to ensure better medical care and an adequate response to population needs. This study can support local authorities in optimising spatial accessibility to cardiovascular care by identifying the most burdened hospitals in the context of low medical specialised staff and large catchment areas.