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A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

BACKGROUND: This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibilit...

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Autores principales: Comber, Alexis J, Brunsdon, Chris, Radburn, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155965/
https://www.ncbi.nlm.nih.gov/pubmed/21787394
http://dx.doi.org/10.1186/1476-072X-10-44
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author Comber, Alexis J
Brunsdon, Chris
Radburn, Robert
author_facet Comber, Alexis J
Brunsdon, Chris
Radburn, Robert
author_sort Comber, Alexis J
collection PubMed
description BACKGROUND: This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. METHODS: Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. RESULTS: Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. CONCLUSIONS: Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned.
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spelling pubmed-31559652011-08-16 A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions Comber, Alexis J Brunsdon, Chris Radburn, Robert Int J Health Geogr Research BACKGROUND: This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. METHODS: Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. RESULTS: Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. CONCLUSIONS: Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. BioMed Central 2011-07-25 /pmc/articles/PMC3155965/ /pubmed/21787394 http://dx.doi.org/10.1186/1476-072X-10-44 Text en Copyright ©2011 Comber et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Comber, Alexis J
Brunsdon, Chris
Radburn, Robert
A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title_full A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title_fullStr A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title_full_unstemmed A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title_short A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
title_sort spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155965/
https://www.ncbi.nlm.nih.gov/pubmed/21787394
http://dx.doi.org/10.1186/1476-072X-10-44
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