Comparing Alternative Methods of Measuring Geographic Access to Health Services
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Objective: This research compared alternative measures of geographic access to health care providers using different levels of spatial aggregation (county, zipcode and street) and different methods of calculating the cost of space (Euclidean distance, road distance and travel time).
Data Sources: The research is based on a community-based sample of rural (74%) and urban (26%) Arkansans (n=435) and all medical providers (n=3,419) and mental health specialists (n=1,034) practicing in the state of Arkansas in 1993.
Study Design: A cross-sectional study design was used to determine the availability of and accessibility to general medical and specialty mental health providers. Accessibility was defined as the travel time between each subject and the closest provider. Availability was defined as the number of providers within 30 minutes travel time of each subject.
Data Collection: A Geographic Information System was used to geocode subjects and providers at the county, zip code and street levels, and to calculate the travel times, road distances and Euclidean distances between subjects and providers.
Principal Findings: Regression results demonstrated that the most commonly used county-based measures of geographic access (e.g., MSA designation and providers per capita) explained 3%–10% of the variation in accessibility and 34%–70% of the variation in availability.
Conclusions: Results indicate that Geographic Information Systems can be used to accurately measure geographic access to health services in a cost effective manner.
- D. Albert and W. Gesler. “Multiple Locations of Practice in North Carolina: Findings and Health Care Policy Implications”, Carolina Health Services and Policy Review, vol. 4, pp. 55-75, 1997.
- L. Anselin. Spatial Econometrics: Methods and Models. Kluwer Academic Publishers: Dordrecht, Netherlands, 1988.
- J. Brimberg and R. Love. “A New Distance Function for Modeling Travel Distances in a Transportation Network”, Transportation Science. Vol. 26,No. 2, pp. 129-137, 1992.
- J. Fortney, M. Zhang, J. Warren and K. Rost. “The Impact of Geographic Accessibility on the Intensity and Quality of Depression Treatment”, Medical Care, Vol. 27,no. 9, pp. 884-893, 1999.
- A. Geronimus, J. Bounnd and L. Neidert. “On the Validity of Using Census Geocode Characteristics to Proxy Individual Socioeconomic Characteristics”, Journal of the American Statistical Association, Vol. 91,no. 434, pp. 529-537, 1996.
- D. Goodman, E. Fischer, T. Stukel and C. Chang. “The Distance to Community Medical Care and the Likelihood of Hospitalization: Is Closer Always Better?” American Journal of Public Health, Vol. 87,no. 7, pp. 1144-1150, 1997.
- Jacoby Itzhak, “Geographic Distribution of Physician Manpower: The GMENAC Legacy”, Journal of Rural Health, Vol. 7,no. 4. supplemental, pp. 427-436, 1991.
- J. Kleinman and D. Makuc. “Travel for Ambulatory Care”, Medical Care, Vol. 21, pp. 543-557, 1983.
- R. Penchansky and J.W. Thomas, “The Concept of Access: Definition and Relationship to Consumer Satisfaction”, Medical Care, Vol. 19,no. 2, pp. 127-140, 1981.
- C. Phibbs and H. Luft. “Correlation of Travel Time on Roads Versus Straight Line Distance”, Medical Care Research and Review, Vol. 52,no. 4, pp. 532-542, 1995.
- T. Ricketts and L. Savitz. Access to Health Services in Geographic Methods for Health Services Research, A Focus on the Rural-Urban Continuum, editors T. Ricketts, L. Savitz, W. Gesler and D. Osborne, University Press of America Inc. Lanham, MD, 1994.
- R. Rost, M. Zhang, J. Fortney, J. Smith and G.R. Smith. “Rural-Urban Differences in Depression Treatment and Suicidality”, Medical Care, Vol. 36,no. 7, pp. 1098-1107, 1998.
- S. Walsh, P. Page and W. Gesler. “Normative Models and Healthcare Planning: Network-Based Simulations Within a Geographic Information System Environment”, Health Services Research, Vol. 32,no. 2, pp. 243-260, 1997.
- Comparing Alternative Methods of Measuring Geographic Access to Health Services
Health Services and Outcomes Research Methodology
Volume 1, Issue 2 , pp 173-184
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- geographic access
- geographic information system
- travel time