Spatial Inequality in the Accessibility to Hospitals in Greece (original) (raw)
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Modelling spatial accessibility to medical care. Case study of the North-Eastern Region of Romania
Providing the entire population with the same accessibility to services of general interest is among the priorities of EU policy. Among these services, those concerned with medical treatment occupy a special place due to their social and economic importance. The study raises the issue of modelling the population’s spatial accessibility to medical services in the North-Eastern Region of Romania. A trans-scalar methodology that has been tailored to the specific features of the Romanian medical system was employed for computing indexes of accessibility. The methodology brings together into one synthetic indicator five hierarchical levels of analysis, the geographical proximity of service centres, their degree of attractiveness and the potential need for medical services at local level. The results highlight areas with different levels of accessibility to medical services and their dysfunctionalities according to each variable employed in the analysis. - See more at: http://www.humangeographies.org.ro/volume-9-issue-2-2015/923-abstract#sthash.TKxhIUeM.dpuf
It is important for health planners to provide health services as effectively and equitably as possible for the development of quality living environments. The provision of adequate healthcare services, particularly in metropolitan areas, is becoming more difficult because of three developments: slow economic growth; the rapid growth of metropolitan areas and their subsequent increases in population. It is thus a challenge to provide what is considered a fair or socially just distribution of healthcare services to a population with changing healthcare needs. The spatial distribution of people and their varying need for healthcare services is a long-standing interest in the field of service planning, and provides a classic issue well suited for Geographical Information Systems (GIS) to analyse. Access is an important aspect in healthcare service planning. GIS-based accessibility analysis is a logical method that can be applied to test the degree to which access is obtained. Such successful applications of GIS-based analysis have been useful in indicating the accessibility of an existing or potential service. This has provided a good basis for the planning of healthcare services. However, it has been increasingly realised that there is a growing need for a paradigm shift in the planning process. In South Africa, primary healthcare (PHC) is a dual system made up of private and public healthcare facilities. Private PHC is expensive and only affordable to people with medical insurance. These people, most currently belonging to the middle and high income brackets, are theoretically also healthier than the rest of the population. But a small proportion of the population in the low income bracket also has medical aid or insurance. Hence, it is quite difficult to make a clear distinction of the low, middle and high income uninsured population when measuring access to public primary healthcare services. In this study, three different scenarios to calculate the uninsured population were generated and tested using a GIS-based form of catchment area analysis. The results from the catchment area analysis were compared with actual public PHC demand in the form of headcounts and further analysis of the origins of the patients was undertaken using a patient register. Results indicate that there is no significant difference in the spatial extent of the catchment areas of the facilities across the three demand scenarios but that there are significant differences in demand visits per scenario. A patient register and facility headcounts, both based on actual visits to public PHC facilities, were compared to the results of the catchment area analysis. The comparison results show that almost 45% of the patients did not use their closest facility as a first point of contact. The total allocated demand visits in scenario 3 was strongly in line with the total number of headcounts of the area, and thus is considered the most suitable calculation of uninsured population for implementation in a GIS-based accessibility analysis.
Spatial accessibility assessment to healthcare facilities: urban and rural areas
E3S Web of Conferences, 2021
This research concentrates on the spatial accessibility assessment to healthcare facilities. Specifically, in doing so it compares the situation in urban and rural areas. In many countries, health inequalities continue to be a major public health challenge. Furthermore, there is also urbanization that occurs when people move from rural areas to urban areas. It leads to an increase in urban population and the extent of urban areas. Driven by population growth, many cities in low and middle-income countries are growing at record rates which puts large pressure on the healthcare system and facilities. Our research demonstrates that due to many political, economic, social and cultural factors, the current inequalities in health care between regions, urban and rural areas and different age and income groups are increasing. Thence, there is a pressing need for the improvement of the healthcare in the lagged regions and areas using such means as the advanced technologies, analysis of data,...
International Journal of Environmental Research and Public Health
The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service from Google Maps and open data sources. Based on real-time traffic navigation data, we examined the potential accessibility of hospitals through a weighted model that took into account the hospital competency level and travel time while using personal car transportation mode. Two scenarios were generated that depend on hospitals’ level of competency (I–V). When considering all categories of hospitals, access is relatively good with over 80% of the population reaching hospitals in less than 30 min. This is much lower in the case of hospitals that provide complex care, with 34% of the population travelling between 90 to 120 min to the nearest hospital classed in the...
Disparities in Geographical Access to Hospitals in Portugal
ISPRS International Journal of Geo-Information
Geographical accessibility to health care services is widely accepted as relevant to improve population health. However, measuring it is very complex, mainly when applied at administrative levels that go beyond the small-area level. This is the case in Portugal, where the municipality is the administrative level that is most appropriate for implementing policies to improve the access to those services. The aim of this paper is to assess whether inequalities in terms of access to a hospital in Portugal have improved over the last 20 years. A population-weighted driving time was applied using the census tract population, the roads network, the reference hospitals’ catchment area and the municipality boundaries. The results show that municipalities are 25 min away from the hospital—3 min less than in 1991—and that there is an association with premature mortality, elderly population and population density. However, disparities between municipalities are still huge. Municipalities with h...
Geographica Pannonica
The application of geographical information systems (GIS) to the assessment of accessibility to hospitals has been investigated for an important growth pole in SouthEast Europe, respectively Bucharest and its metropolitan area. The calculation of accessibility at an intra-regional level is essential, taking into consideration the major role as a capital city, as well as the magnitude of the influence exercised over its hinterland. The territorial dynamics, characterizing a metropolis and also the attraction on a constant number of people, may raise a number of issues such as overcrowding of the main access roads into the city, the pressure put on the public transportation network, the rise of the number of personal cars, which is linked to the longer time needed to travel to various services areas.
2018
Introduction: Unfair distribution of healthcare services is one of the most important issues all over the world. The present study aimed to determine the distribution pattern of available hospital beds and the accessibility pattern to hospitals in Shiraz. Methods: This was an analytical study. At first, spatial distribution pattern of available hospital beds was determined using Moran’s Index (Moran’s I). Then, the accessibility pattern to hospitals was determined using Euclidean distance and network travel distance metrics. Allof the analyses were conducted using Arc GIS (10.3) software. Results: The results revealed that available hospital beds had a random and unbalanced distribution pattern in Shiraz based on Moran’s I (Moran’s I=-0.05). Besides, according the achieved standard service areas for the existing hospitals, calculated by using Network analysis tools, 65.47% of Shiraz population was underserved in terms of accessibility. Furthermore, assessment of accessibility patter...
Evaluation of Greek Public Hospitals' allocation in Central Macedonia
In order to contribute to the deeper understanding of health domain and assist the community to prepare to meet possible health related risks, health monitoring and exploring procedures using Geographical Information Science are considered of critical importance. This study aimed at depthening of the understanding of the health environment in Central Macedonia, Northern Greece through the utilization of a socio-spatial dialectic. Arc-GIS software was the instrument of choice to organize and analyze the data in an effort to investigate the satisfaction level and the accessibility status of Chronic Disease Patients towards public hospitals of Central Macedonia in Greece. The final outcome revealed that there is no significant need to make adjustments in the distribution of public hospitals.
International journal of scientific and research publications, 2018
Access to health care is considered to be of great importance for a person’s right to health. This paper attempts to highlight the spatial disparities in access to and use of rehabilitation services across Imathia’s area in Northern Greece. Our study is being focused on one defined geographical area, Imathia, in Macedonia in northern Greece. We defined a public general hospital as a local National Health System institution providing health services for the purpose of rehabilitation concerning patients with musculoskeletal disorders. The implementation of data included descriptive and concluding statistical processing. The spatial data was visualized in points and polygons. Most patients (60.5%) are from areas near to the hospital which means that there, is more concentration. The research focuses on spatial disparities and does not deal with their causes. As a consequence these findings raise important research questions for future investigation.