Skip to main content

Advertisement

Log in

A Literature Review of the Use of GIS-Based Measures of Access to Health Care Services

  • Published:
Health Services and Outcomes Research Methodology Aims and scope Submit manuscript

Abstract

The increasing availability of Geographical Information Systems (GIS) in health organisations, together with the proliferation of spatially disaggregate data, has led to a number of studies that have been concerned with developing measures of access to health care services. The main aim of this paper is to review the use of GIS-based measures in exploring the relationship between geographic access, utilisation, quality and health outcomes. The varieties of approaches taken by researchers concerned with teasing out the relative importance of geographical factors that may influence access are examined. To date, in the absence of detailed data on health utilisation patterns, much of this research has focused on developing measures of potential accessibility. This paper then critically evaluates the situation with regard to the use of such measures in a broad range of accessibility studies. In particular, there has been less research to date that examines the relationship between such measures and health outcomes. In the final sections of the paper, I draw on the review to outline areas where a broader research agenda is needed, particularly in relation to more recent innovations in health care delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aday, L.A. and Andersen, R., “A framework for the study of access to medical care,” Health Services Research 9, 208–220, 1974.

    PubMed  CAS  Google Scholar 

  2. Andersen, R.M., “Revisiting the behavioural model and access to medical care,” Journal of Health and Social Behaviour 36(1), 1–10, 1995.

    Article  CAS  Google Scholar 

  3. Andersen, R.M. and Aday, L.A., “Access to medical care in the US: Realised and potential,” Medical Care 16, 533–546, 1978.

    PubMed  CAS  Google Scholar 

  4. Asthana, S., Gibson, A., Moon, G., Dicker, J., and Brigham, P., “The pursuit of equity in NHS resource allocation: Should morbidity replace utilisation as the basis for setting health care capitations,” Social Science and Medicine 2003.

  5. Bamford, E.J., Dunne, L., Taylor, D.S., Symon, B.G., Hugo, G.J., and Wilkinson, D., “Accessibility to general practitioners in rural South Australia: A case study using geographic information system technology, Medical Journal of Australia, 171, 614–616, 1999.

    Google Scholar 

  6. Bentham, G., Hinton, J., Haynes, R., Lovett, A., and Bestwick, C., “Factors affecting non-response to cervical cytology screening in Norfolk, England,” Social Science Medicine 40(1), 131–135, 1995.

    Article  PubMed  CAS  Google Scholar 

  7. Bhana, A. and Pillay, Y.G., “The use of geographical information system to determine potential access and allocation of public mental health resources in KwaZulu-Natal,” South African Journal of Psychology 28(4), 222–233, 1998.

    Google Scholar 

  8. Brabyn, L. and Gower, P., “Mapping Accessibility to General Practitioners, in O. Khan and R. Skinner (eds.), Geographic Information Systems and Health Applications Idea Group Publishing, Hershey, PA., 289–307, 2003.

  9. Brabyn, L. and Skelly, C., “Modelling population access to New Zealand public hospitals,” International Journal of Health Geographics 1(3), 1–9, 2002.

    Google Scholar 

  10. Bryant, J., Browne, A.J., Barton, S., and Zumbo, B.D., “Access to health care: Social determinants of preventive cancer screening use in Northern British Columbia,” Social Indicators Research 60, 243–262, 2002.

    Article  Google Scholar 

  11. Burt, J., Hooper, R., and Jessopp, L., “The relationship between use of NHS Direct and deprivation in southeast London: An ecological analysis,” Journal of Public Health Medicine 25(2), 174–176, 2003.

    Article  PubMed  Google Scholar 

  12. Campbell, N.C., Elliott, A.M., Sharp, L., Ritchie, L.D., Cassidy, J., and Little, J., “Rural factors and survival from cancer: Analysis of Scottish cancer registrations, British Journal of Cancer 82, 1863–1866, 2000.

    Article  PubMed  CAS  Google Scholar 

  13. Campbell, N.C., Elliott, A.M., Sharp, L., Ritchie, L.D., Cassidy, J., and Little, J., “Rural and urban differences in stage of diagnosis of colorectal and lung cancers, British Journal of Cancer 84, 910–914, 2001.

    Article  PubMed  CAS  Google Scholar 

  14. Carriere, K.C., Roos, L.L., and Dover, D.C., “Across time and space: Variations in hospital use during canadian health reform,” Health Services Research 35(2), 467–487, 2000.

    PubMed  CAS  Google Scholar 

  15. Charlton, M., Fotheringham, A.S., and Brunsdon, C., “Analysing access to hospital facilities with GIS in Regional Science in Business (G. Clarke and M. Madden, eds.), Springer Verlag: Berlin, 283–304, 2001.

  16. Coleman, M.P., Babb, P., Sloggett, A., Quinn, M., and de Stavola, B., “Socio-economic inequalities in cancer survival in England and Wales,” Cancer 91, 208–216, 2001.

    Article  PubMed  CAS  Google Scholar 

  17. Cromley, E.K. and McLafferty, S.L., GIS and public health, Guilford Press, New York, 2002.

    Google Scholar 

  18. Department of Health, Improvement, expansion and reform: The next 3 years; priorities and planning framework, 2003–2006, Department of Health, London, 2002.

  19. Field, K., “Measuring the need for primary health care: An index of relative disadvantage,” Applied Geography, 20, 305–332, 2000.

    Article  Google Scholar 

  20. Field, K. and Briggs, D.J., “Socio-economic and locational determinants of accessibility and utilisation of primary health care,” Health and Social Care in the Community 9(5), 294–308, 2001.

    Article  PubMed  CAS  Google Scholar 

  21. Fortney, J., Rost, K., and Warren, J., “Comparing alternative methods of measuring geographic access to health services,” Health Services and Outcomes Research Methodology 1(2), 173–184, 2000.

    Article  Google Scholar 

  22. Fortney, J., Rost, K., Zhang, M., and Warren, J., “The impact of geographic accessibility on the intensity and quality of depression treatment,” Medical Care 37, 884–893, 1999.

    Google Scholar 

  23. Gatrell, A.C., Garnett, S., Rigby, J., et al., “Uptake of screening for breast cancer in South Lancashire,” Public Health 112(5), 297–301, 1998.

    Article  PubMed  CAS  Google Scholar 

  24. Gatrell, A. and Senior, M., “Health and health care applications”, in Geographical Information Systems: Principles a‘nd Applications, second edition, (Longley, P.A., Maguire, D.J., Goodchild, M.F., and Rhind, D.W., eds.), Longman, London, 1999.

  25. Guagliardo, M.F., “Spatial accessibility of primary care: Concepts, methods and challenges,” International Journal of Health Geographics, 3:3, 2004.

    Google Scholar 

  26. Guagliardo, M.F., Ronzio, C.R., Cheung, I., Chacko, E., and Joseph, J.G., “Physican accessibility: An urban case study of pediatric providers,” Health & Place 10, 273–283, 2004.

    Article  Google Scholar 

  27. Gulliford, M., “Availability of primary care doctors and population health in England: Is there an association,” Journal of Public Health Medicine 24(4), 252–254, 2002.

    Article  PubMed  Google Scholar 

  28. Gulliford, M. and Morgan, M., Access to health care, Routledge, London, 2003.

    Google Scholar 

  29. Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., and Hudson, M., “What does ‘access to health care' mean?,” Journal of Health Services Research and Policy, 7(3), 186–188, 2002.

    Article  PubMed  Google Scholar 

  30. Halden, D., McGuigan, D., Nisbet, A., and McKinnon, A., “Accessibility: Review of measuring techniques and their application,” Scottish Executive Central Research Unit 2000.

  31. Handy, S.L. and Niemeier, D.A., “Measuring accessibility: An exploration of issues and alternatives,” Environment and Planning A, 29, 1175–1194, 1997.

    Google Scholar 

  32. Hansen, W.G., “How accessibility shapes land use,” Journal of the American Institute of Planners 25, 73–76, 1959.

    Google Scholar 

  33. Haynes, R.M., “Geographical access to health care,” Chapter 2 in Access to Health Care, (M. Gulliford and M. Morgan, eds.), Routledge, London, 13–35, 2003.

  34. Haynes, R.M., Bentham, G., Lovett, A., and Gale, S., “Effects of distances to hospital and GP surgery on hospital inpatient episodes, controlling for needs and provision,” Social Science and Medicine 49(3), 425–433, 1999.

    Article  PubMed  CAS  Google Scholar 

  35. Haynes, R., Lovett, A., and Sunnenberg, G., “Potential accessibility, travel time, and consumer choice: Geographical variations in general medical practice registrations in Eastern England,” Environment and Planning A 35(10) 1733–1750, 2003.

    Article  Google Scholar 

  36. Hewko, J., Smoyer-Tomic, K.E., and Hodgson, M.J., “Measuring neighbourhood spatial accessibility: Does aggregation error matter,” Environment and Planning A 34, 1185–1206, 2002.

    Article  Google Scholar 

  37. Higgs, G. and Gould, M., “Is there a role for GIS in the ‘New NHS'?,” Health and Place 7(3), 247–259, 2001.

    Article  PubMed  CAS  Google Scholar 

  38. Higgs, G., and White, S., “Alternative Indicators of Social Disadvantage in rural communities: The example of Rural Wales,” Progress in Planning 53(1), 1–81, 2000.

    Article  Google Scholar 

  39. Hyndman, J.C.G. and Holman, C.D.J., “Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage,” Social Science and Medicine 53, 1599–1609, 2001.

    Article  PubMed  CAS  Google Scholar 

  40. Hyndman, J.C.G., Holman, C.D.J., and Dawes, V.P., “Effect of distance and social disadvantage on the response to invitations to attend mammography screening,” Journal of Medical Screening 7, 141–145, 2000.

    Article  PubMed  CAS  Google Scholar 

  41. Jack, R.H., Gulliford, M.C., Ferguson, J., and Moller, H., “Geographical inequalities in lung cancer management and survival in South East England: Evidence of variation in access to oncology services?,” British Journal of Cancer 88(7), 1025–1031, 2003.

    Article  PubMed  CAS  Google Scholar 

  42. Jones, A.P. and Bentham, G., “Emergency medical service accessibility and outcome from road traffic accidents,” Public Health 109, 169–177, 1995.

    Article  PubMed  CAS  Google Scholar 

  43. Jones, A.P., Bentham, G., Harrison, B.D.W., Jarvis, D., Badminton, R.M., and Wareham, N.J., “Accessibility and health service utilization for asthma in Norfolk, England,” Journal of Public Health Medicine 20(3), 312–317, 1998.

    PubMed  CAS  Google Scholar 

  44. Jones, A.P., Bentham, G., and Horwell, C., “Health service accessibility and deaths from asthma,” International Journal of Epidemiology 28, 101–105, 1999.

    Article  PubMed  CAS  Google Scholar 

  45. Jones, M., Ramsay, J., Feder, G., Crook, A.M., and Hemingway, H., “Influence of practices' ethnicity and deprivation on access to angiography: An ecological study,” British Journal of General Practice 54, 423–428, 2004.

    PubMed  Google Scholar 

  46. Joseph, A.E. and Bantock, P.R., “Measuring potential physical accessibility to general practitioners in rural areas: A method and case study,” Social Science and Medicine 16, 85–90, 1982.

    Article  PubMed  CAS  Google Scholar 

  47. Joseph, A.E. and Phillips, D.R. Accessibility and utilization: Geographical perspectives on health care delivery, Harper & Row, London, UK, 1984.

    Google Scholar 

  48. Juarez, P.D., Robinson, P.L., and Matthews-Juarez, P., “100% access, zero health disparities, and GIS: An improved methodology for designating health professions shortage areas,” Journal of Health and Social Policy 16(1/2), 155–167, 2002.

    Article  PubMed  Google Scholar 

  49. Khan, A.A., “An integrated approach to measuring potential spatial access to health care services,” Socio-economic Planning Sciences 26(4), 275–287, 1992.

    Article  PubMed  CAS  Google Scholar 

  50. Kim, Y-E., Gatrell, A.C., and Francis, B.J., “The geography of survival after surgery for colorectal cancer in southern England,” Social Science and Medicine, 50, 1099–1107, 2000.

    Article  PubMed  CAS  Google Scholar 

  51. Knapp, K.K. and Hardwick, K., “The availability and distribution of dentists in rural ZIP codes and primary care health professional shortage areas (PC-HPSA) ZIP codes: Comparison with primary care providers,” Journal of Public Health Dentistry 60(1), 43–48, 2000.

    PubMed  CAS  Google Scholar 

  52. Knox, P.L., (1978) “The intra-urban ecology of primary medical care: Patterns of accessibility and their policy implications,” Environment and Planning A 10, 415–435.

    Google Scholar 

  53. Knox, P.L., “The accessibility of primary care to urban patients: A geographical analysis,” British Journal of General Practice 29, 160–168, 1979.

    CAS  Google Scholar 

  54. Koenig, J.G., “Indicators of urban accessibility; theory and application,” Transportation 9(2), 145–172, 1980.

    Article  Google Scholar 

  55. Kohli, S., Shalen, K., Sivertun, A., Lofman, O., Trell, E., and Wigertz, O., “Distance from the Primary Health Center: A GIS method to study geographical access to health care,” Journal of Medical Systems 19(6), 425–436, 1995.

    Article  PubMed  CAS  Google Scholar 

  56. Kwan, M.P. and Weber, J., “Individual accessibility revisited: Implications for geographical analysis in the twenty first century,” Geographical Analysis 35(4), 341–353, 2003.

    Google Scholar 

  57. Launoy, G., le Coutour, X., Gignoux, P., Pottier, D., and Dugleux, G., “Influence of rural environment on diagnosis, treatment and prognosis of colorectal cancer, Journal of Epidemiology and Community Health 46, 365–367, 1992.

    Article  PubMed  CAS  Google Scholar 

  58. Lin, G., “Using GIS to unveil distance effects on hospitalisations in Victoria,” in Geographic Information Systems and Health Applications, (Khan, O. and Skinner, R., eds.), Idea Group Publishing, Hershey, PA. 243–259, 2003.

  59. Lin, G., Allan, D.E., Penning, M.J., “Examining distance effects on hospitalizations using GIS: A study of three health regions in British Columbia, Canada,” Environment and Planning A 34(11), 2037–2053, 2002.

    Article  Google Scholar 

  60. Liu, S. and Zhu, X., “An integrated GIS approach to accessibility analysis,” Transactions in GIS 8(1), 45–62, 2004.

    Article  Google Scholar 

  61. Love, D. and Lindquist, P., “The geographical accessibility of hospitals to the aged: A geographic systems analysis within Illinois,” Health Services Research 29, 629–651, 1995.

    PubMed  CAS  Google Scholar 

  62. Lovett, A., Haynes, R., Sunnenberg, G., and Gale, S., “Car travel time and accessibility by bus to general practitioner services: A study using patient registers and GIS,” Social Science and Medicine 55(1), 97–111, 2002.

    Article  PubMed  Google Scholar 

  63. Luo, W., “Using a GIS-based floating catchment method to assess areas with shortage of physicians, Health, Place 10, 1–11, 2004.

    Article  Google Scholar 

  64. Luo, W. and Wang, F., “Measures of spatial accessibility to health care in a GIS environment: Synthesis and a case study in the Chicago region,” Environment and Planning B: Planning and Design 30, 865–884, 2003.

    Article  Google Scholar 

  65. McLafferty, S.L., “GIS and health care,” Annual Review of Public Health 24, 25–42, 2003.

    Article  PubMed  Google Scholar 

  66. Maheswaran, R., Payne, N., Meechan, D., Burden, R.P., Fryers, P.R., Wight, J., and Hutchinson, A., “Socio-economic deprivation, travel distance and renal replacement therapy in the Trent Region, United Kingdom 2000: An ecological study,” Journal of Epidemiology and Community Health 57(7), 523–524, 2003.

    Article  PubMed  CAS  Google Scholar 

  67. Makuc, D.M., Haglund, B., Ingram, D.D., Kleinman, J.C., and Feldman, J.J., “The use of Health Service Areas for measuring provider availability, The Journal of Rural Health 7(4), 347–356, 1991.

    PubMed  CAS  Google Scholar 

  68. Martin, D., Roderick, P., Diamond, I., Clements, S., and Stone, N., “Geographical aspects of the uptake of renal replacement therapy in England,” International Journal of Population Geography 4, 227–242, 1998.

    Article  Google Scholar 

  69. Martin, D. and Williams, H.C.W.L., “Market area analysis and accessibility to primary health care centres,” Environment and Planning A 24(7), 1009–1019, 1992.

    Google Scholar 

  70. Martin, D., Wrigley, H., Barnett, S., and Roderick, P., “Increasing the sophistication of access measurement in a rural healthcare study,” Health & Place, 8, 3–13, 2002.

    Article  CAS  Google Scholar 

  71. Noor, A.M., Zurovac, D., Hay, S.I., Ochola, S.A., and Snow, S.W., “Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya,” Tropical Medicine and International Health 8(10), 917–926, 2003.

    Article  PubMed  CAS  Google Scholar 

  72. Oppong, J.R. and Hodgson, M.J., “Spatial accessibility to health care facilities in Suhum district, Ghana,” Professional Geographer 46(2), 199–209, 1994.

    Article  Google Scholar 

  73. Parker, E.B., and Campbell, J.L., “Measuring access to primary medical care: Some examples of the use of geographical information systems,” Health & Place” 4(2), 183–193, 1998.

    Article  CAS  Google Scholar 

  74. Penchansky, R. and Thomas, J.W., “The concept of access,” Medical Care 19, 127–40, 1981.

    PubMed  CAS  Google Scholar 

  75. Perry, B. and Gesler, W., “Physical access to primary health care in Andean Bolivia,” Social Science and Medicine 40, 1177–1188, 2000.

    Google Scholar 

  76. Phillips, R.L., Kinman, E.L., and Lindbloom, E.J., “Using geographic information systems to understand health care access,” Arhives Family Medicine 9, 971–978, 2000.

    Article  Google Scholar 

  77. Philo, C., Parr, H., and Burns, N., “Rural madness: A geographical reading and critique of the rural mental health literature,” Journal of Rural Studies 19(3), 259-396, 2003.

    Article  Google Scholar 

  78. Pitchforth, E., Russell, E., and Van der Pol, M., “Access to specialist cancer care: Is it equitable,” British Journal of Cancer 87, 1221–1226, 2002.

    Article  PubMed  CAS  Google Scholar 

  79. Pooley, C.G., Briggs, J., Gatrell, T., Mansfield, T., Cummings, D., and Deft, J., “Contacting your GP when the surgery is closed: Issues of location and access,” Health and Place 9, 23–32, 2003.

    Article  PubMed  Google Scholar 

  80. Radke, J. and Mu, L., “Spatial decomposition, modelling and mapping service regions to predict access to social programs,” Geographic Information Sciences 6, 105–112, 2000.

    Google Scholar 

  81. Rosero-Bixby, L., “Spatial access to health care in Costa Rica and its equity: A GIS-based study,” Social Science & Medicine 58, 1271–1284, 2003.

    Article  Google Scholar 

  82. Rushton, G., “Methods to evaluate geographic access to health services,” Journal of Public Health Management and Practice 5(2), 93–100, 1999.

    PubMed  CAS  Google Scholar 

  83. Schellenberg, J.A., Newell, J.N., Snow, R.W., Mung'ala, V., Marsh, K., Smith, P.G., and Hayes, R.J., “An analysis of the geographical distribution of severe malaria in children in Kilifi District, Kenya,” International Journal of Epidemiology 27, 323–329, 1998.

    Article  PubMed  CAS  Google Scholar 

  84. Scott, D., Curtis, B., and Twumasi, F.O., “Towards the creation of a health information system for cancer in KwaZulu-Natal, South Africa,” Health & Place 8(4), 237–249, 2002.

    Article  Google Scholar 

  85. Scott, P.A., Temovsky, C.J., Lawrence, K., Gudaitis, E., and Lowell, M.J., “Analysis of Canadian Population with potential geographic access to intravenous thrombolysis for acute ischemic stroke,” Stroke 29, 2304–2310, 1998.

    PubMed  CAS  Google Scholar 

  86. Sheehan, T.J., Gerschman, S.T., MacDougall, L.A., Danley, R.A., Mroszczyk, M., Sorenson, A.M., and Kulldorff, M., “Geographic assessment of breast cancer screening by towns, zip codes, and census tracts,” Jounral of Public Health Management Practice 6(6), 48–57, 2000.

    CAS  Google Scholar 

  87. Slack, A., Cumming, J., Mare, D., and Timmins, J., “Variations in secondary care utilisation and geographic access: initial analysis of 1996 data,” in Proceedings of GeoHealth 2002, (Rigby, J., Skelly, C., and Whigham, P.A., eds.), 105–114, 2002.

  88. Smith, S.M. and Campbell, N.C., “Provision of oncology services in remote rural areas: A Scottish perspective,” European Journal of Cancer Care 13, 185–192, 2004.

    Article  PubMed  CAS  Google Scholar 

  89. Smoyer-Tomic K., Hewko J.N., and Hodgson M.J., “Spatial accessibility and equity of playgrounds n Edmonton Canada,” The Canadian Geographer 48(3), 287–302, 2004.

    Article  Google Scholar 

  90. Susi, L. and Mascarenhas, A.K., “Using a geographical information system to map the distribution of dentists in Ohio,” Journal of the American Dental Association 133(5), 636–42, 2002.

    PubMed  Google Scholar 

  91. Talen, E. “Neighbourhoods as service providers: A methodology for evaluating pedestrian access,” Environment and Planning B: Planning and Design 30, 181–200, 2003.

    Article  Google Scholar 

  92. Talen, E. and Anselin, L., “Assessing spatial equity: An evaluation of measures of accessibility to public playgrounds,” Environment and Planning A 30, 595–613, 1998.

    Google Scholar 

  93. Tanser, F., Hosegood, V., Benzler, J., and Solarsh, G., “New approaches to spatially analyse primary health care usage patterns,” Tropical Medicine and International Health 6(10), 826–838, 2001.

    Article  PubMed  CAS  Google Scholar 

  94. Tanser, F., LeSueur, D., Solarsh, G., and Wilkinson, D., “HIV heterogeneity and proximity of homestead to roads in rural South Africa: An exploration using a geographical information system, Tropical Medicine and International Health 5(1), 40–46, 2000.

    Article  PubMed  CAS  Google Scholar 

  95. Tanser, F., and Wilkinson, D., “Spatial implications of the tuberculosis DOTS strategy in rural South Africa: A novel application of geographical information system and global positioning system technologies,” Tropical Medicine and International Health 4(10), 634–638, 1999.

    Article  PubMed  CAS  Google Scholar 

  96. Van der Heyden, J.H.A., Demarest, S., Tafforeau, J., and Van Oyen, H., Socio-economic differences in the utilisation of health services in Belgium, Health Policy 65, 153–165, 2003.

    Article  PubMed  CAS  Google Scholar 

  97. Wachs, M. and Kumagai, T.G., “Physical Accessibility as a social indicator,” Socio-Economic Planning Science 7, 437–456, 1973.

    Article  Google Scholar 

  98. Walsh, S.J., Page, P.H., and Gesler, W.M., “Normative models and healthcare planning: network-based simulations within a geographic system environment,” Health Services Research 32, 243–260, 1997.

    PubMed  CAS  Google Scholar 

  99. Wang, F. and Luo, W., “Assessing spatial and nonspatial factors for healthcare access: Towards an integrated approach to defining health professional shortage areas,” Health and Place 11(2), 131–146, 2005.

    Article  PubMed  Google Scholar 

  100. Weber, J. and Kwan, M.P., “Bringing time back in: A study on the influence of travel time variations and facility opening hours on individual accessibility,” Professional Geographer 54(2), 226–240, 2002.

    Article  Google Scholar 

  101. Weber, J. and Kwan, M.P., “Evaluating the effects of geographic contexts on individual accessibility: A multi-level approach,” Urban Geography, 24(8), 647–671, 2003.

    Google Scholar 

  102. Wing, P. and Reynolds, C., “The availability of physician services: A geographic analysis,” Health Services Research 23(5), 649–667, 1988.

    PubMed  CAS  Google Scholar 

  103. Witten, K., Exeter, D., and Field, A., “The quality of urban environments: Mapping variation in access to community resources,” Urban Studies, 40(1), 161–177, 2003.

    Google Scholar 

  104. Wood, D.J. and Gatrell, A.C., “Equity of geographical access to inpatient hospice care within North West England: A Geographical Information Systems (GIS) approach, North West Public Health Observatory and Lancaster University, 2002.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gary Higgs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Higgs, G. A Literature Review of the Use of GIS-Based Measures of Access to Health Care Services. Health Serv Outcomes Res Method 5, 119–139 (2004). https://doi.org/10.1007/s10742-005-4304-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10742-005-4304-7

Keywords

Navigation