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Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil
BACKGROUND: Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568346/ https://www.ncbi.nlm.nih.gov/pubmed/28830521 http://dx.doi.org/10.1186/s12939-017-0645-4 |
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author | Rocha, Thiago Augusto Hernandes da Silva, Núbia Cristina Amaral, Pedro Vasconcelos Barbosa, Allan Claudius Queiroz Rocha, João Victor Muniz Alvares, Viviane de Almeida, Dante Grapiuna Thumé, Elaine Thomaz, Erika Bárbara Abreu Fonseca de Sousa Queiroz, Rejane Christine de Souza, Marta Rovery Lein, Adriana Lopes, Daniel Paulino Staton, Catherine A. Vissoci, João Ricardo Nickenig Facchini, Luiz Augusto |
author_facet | Rocha, Thiago Augusto Hernandes da Silva, Núbia Cristina Amaral, Pedro Vasconcelos Barbosa, Allan Claudius Queiroz Rocha, João Victor Muniz Alvares, Viviane de Almeida, Dante Grapiuna Thumé, Elaine Thomaz, Erika Bárbara Abreu Fonseca de Sousa Queiroz, Rejane Christine de Souza, Marta Rovery Lein, Adriana Lopes, Daniel Paulino Staton, Catherine A. Vissoci, João Ricardo Nickenig Facchini, Luiz Augusto |
author_sort | Rocha, Thiago Augusto Hernandes |
collection | PubMed |
description | BACKGROUND: Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. METHODS: The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. RESULTS: The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. CONCLUSIONS: There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access to emergency and surgical care. However more investments in are necessary to improve small hospitals capabilities to fill this gap. |
format | Online Article Text |
id | pubmed-5568346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55683462017-08-29 Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil Rocha, Thiago Augusto Hernandes da Silva, Núbia Cristina Amaral, Pedro Vasconcelos Barbosa, Allan Claudius Queiroz Rocha, João Victor Muniz Alvares, Viviane de Almeida, Dante Grapiuna Thumé, Elaine Thomaz, Erika Bárbara Abreu Fonseca de Sousa Queiroz, Rejane Christine de Souza, Marta Rovery Lein, Adriana Lopes, Daniel Paulino Staton, Catherine A. Vissoci, João Ricardo Nickenig Facchini, Luiz Augusto Int J Equity Health Research BACKGROUND: Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. METHODS: The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. RESULTS: The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. CONCLUSIONS: There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access to emergency and surgical care. However more investments in are necessary to improve small hospitals capabilities to fill this gap. BioMed Central 2017-08-22 /pmc/articles/PMC5568346/ /pubmed/28830521 http://dx.doi.org/10.1186/s12939-017-0645-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Rocha, Thiago Augusto Hernandes da Silva, Núbia Cristina Amaral, Pedro Vasconcelos Barbosa, Allan Claudius Queiroz Rocha, João Victor Muniz Alvares, Viviane de Almeida, Dante Grapiuna Thumé, Elaine Thomaz, Erika Bárbara Abreu Fonseca de Sousa Queiroz, Rejane Christine de Souza, Marta Rovery Lein, Adriana Lopes, Daniel Paulino Staton, Catherine A. Vissoci, João Ricardo Nickenig Facchini, Luiz Augusto Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title | Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title_full | Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title_fullStr | Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title_full_unstemmed | Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title_short | Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil |
title_sort | addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in brazil |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568346/ https://www.ncbi.nlm.nih.gov/pubmed/28830521 http://dx.doi.org/10.1186/s12939-017-0645-4 |
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