Potential Accessibility, Travel Time, and Consumer Choice: Geographical Variations in General Medical Practice Registrations in Eastern England (original) (raw)
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Social Science & Medicine, 2002
Accessibility to general practitioner (GP) surgeries was investigated in a population study of East Anglia (Cambridgeshire, Norfolk and Suffolk) in the United Kingdom. Information from patient registers was combined with details of general practitioner surgery locations, road network characteristics, bus routes and community transport services, and a geographical information system (GIS) was used to calculate measures of accessibility to surgeries by public and private transport. Outcome measures included car travel times and indicators of the extent to which bus services could be used to visit GP surgeries. These variables were aggregated for wards or parishes and then compared with socioeconomic characteristics of the populations living in those areas. The results indicated that only 10% of residents faced a car journey of more than 10 min to a GP. Some 13% of the population could not reach general medical services by daily bus. For 5% of the population, the car journey to the nearest surgery was longer than 10 min and there was no suitable bus service each weekday. In the remoter rural parishes, the lowest levels of personal mobility and the highest health needs indicators were found in the places with no daytime bus service each weekday and no community transport. The overall extent of accessibility problems and the existence of inverse care law effects in some rural localities have implications for the NHS, which aims to provide an equitable service to people wherever they live. The research also demonstrates the potential of patient registers and GIS as research and planning tools, though the practical difficulties of using these data sources and techniques should not be underestimated.
Social Science & Medicine. Part D: Medical Geography, 1981
In cities where a mixed free-enterprise and public supply system operates, the spatial distribution of health care services and access opportunities of potential consumers to services typically fails to satisfy equity criteria. The pattern of distribution and consumer use of general practitioner (GP) services in metropohtan Adelaide, Australia, are examined. Various theories and models are discussed aimed at furnishing explanations of the spatial behaviour of both facility providers and users. These include traditional location theories, theory of demand for semi-public goods, and behavioural models of user choice. A method of spatial analysis at a disaggregated level of scale to investigate the degree of congruence between potential demand for GP services and likely levels of satisfaction from the available supply of GP services in Adelaide is presented and its planning implications discussed.
International Journal of Population Data Science
IntroductionPoor access to general practice services has been attributed to increasing pressure on the health system more widely and low satisfaction among patients. Recent initiatives in England have sought to expand access by the provision of appointments in the evening and at weekends. Services are provided using a hub model. NHS national targets mandate extended opening hours as a mechanism for increasing access to primary care, based on the assumption that unmet need is caused by a lack of appointments at the right time. However, research has shown that other factors affect access to healthcare and it may not simply be appointment availability that limits an individual's ability to access general practice services. ObjectivesTo determine whether distance and deprivation impact on the uptake of extended hours GP services that use a hub practice model. MethodsWe linked a dataset (N = 25,408) concerning extended access appointments covering 158 general practice surgeries in fo...
Health & Social Care in The Community, 2019
There are ongoing policy concerns surrounding the difficulty in obtaining timely appointments to primary health care services and the potential impact on, for example, attendance at accident and emergency services and potential health outcomes. Using the case study of potential access to primary health care services in Wales, Geographic Information System (GIS)-based tools that permit a consideration of population-to-provider ratios over space are used to examine variations in geographical accessibility to GP surgeries offering appointment times outside of 'core' operating hours. Correlation analysis is used to explore the association of accessibility scores with potential demand for such services using UK Population Census data. Unlike the situation in England, there is a tendency for accessibility to those surgeries offering 'extended' hours of appointment times to be better for more deprived census areas in Wales. However, accessibility to surgeries offering appointments in the evening were associated with lower levels of working age population classed as 'economically active'; i.e. those who could be targeted beneficiaries of policies geared towards 'extended' appointment hours provision. Such models have the potential to identify spatial mismatches of different facets of primary health care, such as 'extended' hours provision available at GP surgeries, and are worthy of further investigation, especially in relation to policies targeted at particular demographic groups.
Primary care is paramount in the health care sector in both developed and developing countries as this helps to maintain a healthy life style for not only the elderly populace but also plays a huge role in the general health upkeep for the entire population because it is quite economical when compared with other secondary care health providers. Numerous academic works have highlighted that a certain populace that resides in unfair areas have accessibility constraints and as such lag behind in getting medical aid. The overall correlation coefficient results from findings showed an overall weak correlation and that the elderly with 40%-78% in the output area and 26%-41% in the lower super output area have relative fair access to General Practitioner surgeries in Cardiff.
Journeys to Health Services in Great Britain: An Analysis of Changing Travel Patterns 1985-2006
Health & Place, 2011
This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data . The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Regression analyses were conducted to investigate the differences between different socio-spatial groups in these indicators over the period 1985-2006. This study found that journey distances to health facilities were significantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. However, most of their rates of utilisation of health services were found to be significantly lower because their journey times were significantly longer and also gradually increased over the periods. These findings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension.
Socio‐economic and locational determinants of accessibility and utilization of primary health‐care
Health & Social Care in the Community, 2001
Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.