Assessing Geographical Inaccessibility to Health Care: Using GIS Network Based Methods

摘要

Disparities in the geographic accessibility to health care may be due to the location/distribution of the population and the characteristics of the transportation infrastructure relative to spatial arrangement of the health care delivery system within a region. Access to health care is a complicated concept and is largely dependent on the characteristics of the population in need of services. The most significant features affecting the health status and health outcomes involve distance between the population’s geographic regions and health care facilities and the travel time taken to reach the health care delivery system. Because of Mississippi's rural nature and uneven distribution of physicians, geographic disparities exist in access to primary care services leaving women, children, elderly and general populations in underserved health care regions. The purpose of the research is to identify hot spots of vulnerable population burdened due to geographical accessibility to right kind of health services. This research investigates these features by using network-based GIS methods in ten counties with urban-rural settings. The methodology assesses the geographic accessibility of three types of critical health care facilities: obstetrician/gynaecology (Women in child bearing age); paediatrics (children) and Trauma/Burn Centers (general population). To examine, using network analyst GIS functionalities, these facilities are geocoded, and optimal travel-time based service areas were generated and pertinent vulnerable population data layers were developed. The results identified hot spots of vulnerable populations residing outside the optimal service areas, with rural regions and pregnant women bearing most of the health burden due to geographic inaccessibility. This GIS methodology equip health administrators and policy makers in providing comprehensive view of the health systems from a territorial perspective while assisting them in making conscious policy decisions.