A GIS-based approach to the characterisation of spatial accessibility to primary health care facilities in the Melbourne metropolitan area

摘要

Easy access to location based primary health care facilities, like general practitioner (GP) and dental clinics and pharmacies, are essential to our wellbeing and quality of life. Adequate and equitable provision of primary health care to spatially dispersed population is a key objective and a real challenge for health policy makers in many developed countries, including Australia. This study aims at examining the spatial distribution of population and primary health care facilities in the Melbourne metropolitan area (MMA) and providing accurate, up-to-date and reliable location-based measures of accessibility, as well as spatial variations in location disadvantages, as evidence for supporting spatial optimisation via planning and policy. The study deployed a GIS-based floating catchment area (FCA) method and incorporated network based travel impedance discounted with continuous distance decaying effects to measure spatial accessibility to primary health care facilities in the MMA. Fine resolution spatial data sets used in the study include mesh block level census data on both the total population and its three subgroups (children aged 0-4, females aged 15-44, and seniors aged 65+), detailed road network data, and carefully geocoded address locations of primary health care service provision facilities (GP clinics, pharmacies and dental clinics). The study has revealed fine resolution spatial variations in accessibility to primary health care facilities and identified spatial clusters of residential areas with poor spatial accessibility to the facilities in the MMA. The findings from the study can be useful for efforts that aim at improving the spatial accessibility to primary health care facilities in these disadvantaged residential areas.