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Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care
BACKGROUND: In rural regions with a low population density, distances to health care providers as well as insufficient public transport may be barriers for the accessibility of health care. In this analysis it was examined whether the accessibility of gynecologists and GPs, measured as travel time b...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934853/ https://www.ncbi.nlm.nih.gov/pubmed/29724199 http://dx.doi.org/10.1186/s12913-018-3143-5 |
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author | Stentzel, Ulrike Bahr, Jeanette Fredrich, Daniel Piegsa, Jens Hoffmann, Wolfgang van den Berg, Neeltje |
author_facet | Stentzel, Ulrike Bahr, Jeanette Fredrich, Daniel Piegsa, Jens Hoffmann, Wolfgang van den Berg, Neeltje |
author_sort | Stentzel, Ulrike |
collection | PubMed |
description | BACKGROUND: In rural regions with a low population density, distances to health care providers as well as insufficient public transport may be barriers for the accessibility of health care. In this analysis it was examined whether the accessibility of gynecologists and GPs, measured as travel time both by car and public transport has an influence on the utilization of health care in the rural region of Western Pomerania in Northern Germany. METHODS: Utilization data was obtained from the population based Study of Health in Pomerania (SHIP). Utilization was operationalized by the parameter “at least one physician visit during the last 12 months”. To determine travel times by car and by public transport, network analyses were conducted in a Geographic Information System (GIS). Multivariate logistic regression models were calculated to identify determinants for the utilization of gynecologists and GPs. RESULTS: There is no significant association between the accessibility by car or public transport and the utilization of gynecologists and GPs. Significant predictors for the utilization of gynecologists in the regression model including public transport are age (OR 0.960, 95% CI 0.950–0.971, p < 0.0001), social class (OR 1.137, 95% CI 1.084–1.193, p < 0.0001) and having persons ≥18 years in the household (OR 2.315, 95% CI 1.116–4.800, p = 0.0241). CONCLUSIONS: In the examined region less utilization of gynecologists is not explainable with long travel times by car or public transport. |
format | Online Article Text |
id | pubmed-5934853 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59348532018-05-11 Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care Stentzel, Ulrike Bahr, Jeanette Fredrich, Daniel Piegsa, Jens Hoffmann, Wolfgang van den Berg, Neeltje BMC Health Serv Res Research Article BACKGROUND: In rural regions with a low population density, distances to health care providers as well as insufficient public transport may be barriers for the accessibility of health care. In this analysis it was examined whether the accessibility of gynecologists and GPs, measured as travel time both by car and public transport has an influence on the utilization of health care in the rural region of Western Pomerania in Northern Germany. METHODS: Utilization data was obtained from the population based Study of Health in Pomerania (SHIP). Utilization was operationalized by the parameter “at least one physician visit during the last 12 months”. To determine travel times by car and by public transport, network analyses were conducted in a Geographic Information System (GIS). Multivariate logistic regression models were calculated to identify determinants for the utilization of gynecologists and GPs. RESULTS: There is no significant association between the accessibility by car or public transport and the utilization of gynecologists and GPs. Significant predictors for the utilization of gynecologists in the regression model including public transport are age (OR 0.960, 95% CI 0.950–0.971, p < 0.0001), social class (OR 1.137, 95% CI 1.084–1.193, p < 0.0001) and having persons ≥18 years in the household (OR 2.315, 95% CI 1.116–4.800, p = 0.0241). CONCLUSIONS: In the examined region less utilization of gynecologists is not explainable with long travel times by car or public transport. BioMed Central 2018-05-03 /pmc/articles/PMC5934853/ /pubmed/29724199 http://dx.doi.org/10.1186/s12913-018-3143-5 Text en © The Author(s). 2018 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 Article Stentzel, Ulrike Bahr, Jeanette Fredrich, Daniel Piegsa, Jens Hoffmann, Wolfgang van den Berg, Neeltje Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title | Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title_full | Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title_fullStr | Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title_full_unstemmed | Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title_short | Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care |
title_sort | is there an association between spatial accessibility of outpatient care and utilization? analysis of gynecological and general care |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934853/ https://www.ncbi.nlm.nih.gov/pubmed/29724199 http://dx.doi.org/10.1186/s12913-018-3143-5 |
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