Abstract
Universal access to primary healthcare facilities is a driving goal of healthcare organizations. Despite Canada’s universal access to primary healthcare status, spatial accessibility to healthcare facilities is still an issue of concern due to the non-uniform distribution of primary healthcare facilities and population over space—leading to spatial inequity in the healthcare sector. Spatial inequity is further magnified when health-related accessibility studies are analyzed on the assumption of universal car access. To overcome car-centric studies of healthcare access, this study compares different travel modes—driving, public transit, and walking—to simulate the multi-modal access to primary healthcare services in the City of Calgary, Canada. Improving on floating catchment area methods, spatial accessibility was calculated based on the Spatial Access Ratio method, which takes into consideration the provider-to-population status of the region. The analysis revealed that, in the City of Calgary, spatial accessibility to the primary healthcare services is the highest for the people with an access to a car, and is significantly lower with multimodal (bus transit and train) means despite being a large urban centre. The social inequity issue raised from this analysis can be resolved by improving the city’s pedestrian infrastructure, public transportation, and construction of new clinics in regions of low accessibility.
Highlights
Access to primary healthcare services has long been widely accepted as one of the primary goals in fulfilling the health needs of individuals since these are often the first point of contact in the healthcare system; providing a wide range of services over time that focus on prevention and prognosis of diseases through early diagnosis, contrary to disease-oriented care [1,2,3,4]
This study aimed to calculate the spatial accessibility of primary healthcare facilities by different travel modes in the city of Calgary in the province of Alberta, Canada
A general comparison between spatial accessibility trends by driving, multimodal means, and walking illustrate that there are higher accessibility values estimated in the urban region as compared to suburban regions by all modes of travel (Figure 5, a: road, b: multimodal, and c: walking)
Summary
Access to primary healthcare services (e.g., family doctor) has long been widely accepted as one of the primary goals in fulfilling the health needs of individuals since these are often the first point of contact in the healthcare system; providing a wide range of services over time that focus on prevention and prognosis of diseases through early diagnosis, contrary to disease-oriented care [1,2,3,4]. As of 2016, Canada has 2.6 physicians per 1000 people, which is significantly lower than the Organization for Economic Co-operation and Development (OECD) countries’ average of 3.3 physicians per 1000 population [5]. Lower physician availability status in Canada, compared to the international standards, is escalated by uneven distribution of population and healthcare facilities over regions. The reason behind the ambiguity in defining healthcare access is that it is a multidimensional term. Access can be defined both as a noun, referring to the potential for healthcare use; and, a verb, referring to the interaction between the provider and the patient [3,11]. In order to better interpret access, it has been presented in terms of
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