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Spatial accessibility of primary care: concepts, methods and challenges

Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large sc...

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Autor principal: Guagliardo, Mark F
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC394340/
https://www.ncbi.nlm.nih.gov/pubmed/14987337
http://dx.doi.org/10.1186/1476-072X-3-3
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author Guagliardo, Mark F
author_facet Guagliardo, Mark F
author_sort Guagliardo, Mark F
collection PubMed
description Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. Much less is known about the effect of distance to and supply of primary care on primary care utilization, particularly in the U.S. For several reasons the shortage of information is particularly acute for urban areas, where the majority of people live. First, explicit definitions and conceptualizations of healthcare access have not been widely used to guide research. An additional barrier to progress has been an overwhelming concern about affordability of care, which has garnered the majority of attention and research resources. Also, the most popular measures of spatial accessibility to care – travel impedance to nearest provider and supply level within bordered areas – lose validity in congested urban areas. Better measures are needed. Fortunately, some advances are occurring on the methodological front. These can improve our knowledge of all types of healthcare geography in all settings, including primary care in urban areas. This paper explains basic concepts and measurements of access, provides some historical background, outlines the major questions concerning geographic accessibility of primary care, describes recent developments in GIS and spatial analysis, and presents examples of promising work.
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spelling pubmed-3943402004-04-22 Spatial accessibility of primary care: concepts, methods and challenges Guagliardo, Mark F Int J Health Geogr Review Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. Much less is known about the effect of distance to and supply of primary care on primary care utilization, particularly in the U.S. For several reasons the shortage of information is particularly acute for urban areas, where the majority of people live. First, explicit definitions and conceptualizations of healthcare access have not been widely used to guide research. An additional barrier to progress has been an overwhelming concern about affordability of care, which has garnered the majority of attention and research resources. Also, the most popular measures of spatial accessibility to care – travel impedance to nearest provider and supply level within bordered areas – lose validity in congested urban areas. Better measures are needed. Fortunately, some advances are occurring on the methodological front. These can improve our knowledge of all types of healthcare geography in all settings, including primary care in urban areas. This paper explains basic concepts and measurements of access, provides some historical background, outlines the major questions concerning geographic accessibility of primary care, describes recent developments in GIS and spatial analysis, and presents examples of promising work. BioMed Central 2004-02-26 /pmc/articles/PMC394340/ /pubmed/14987337 http://dx.doi.org/10.1186/1476-072X-3-3 Text en Copyright © 2004 Guagliardo; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Review
Guagliardo, Mark F
Spatial accessibility of primary care: concepts, methods and challenges
title Spatial accessibility of primary care: concepts, methods and challenges
title_full Spatial accessibility of primary care: concepts, methods and challenges
title_fullStr Spatial accessibility of primary care: concepts, methods and challenges
title_full_unstemmed Spatial accessibility of primary care: concepts, methods and challenges
title_short Spatial accessibility of primary care: concepts, methods and challenges
title_sort spatial accessibility of primary care: concepts, methods and challenges
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC394340/
https://www.ncbi.nlm.nih.gov/pubmed/14987337
http://dx.doi.org/10.1186/1476-072X-3-3
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