Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland
Rebecca Evans A B E , Sarah Larkins A B , Tracy Cheffins A , Rhonda Fleming C , Karen Johnston A and Marc Tennant D
+ Author Affiliations
- Author Affiliations
A College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Townsville, Qld 4811 Australia.
B Anton Breinl Research Centre for Health Systems Strengthening, AITHM, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia.
C Townsville Mackay Medicare Local, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia.
D International Research Collaborative – Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
E Corresponding author. Email: rebecca.evans@jcu.edu.au
Australian Journal of Primary Health 23(2) 114-122 https://doi.org/10.1071/PY15175
Submitted: 12 June 2015 Accepted: 24 March 2016 Published: 17 August 2016
Abstract
Australia has seen a significant increase in people aged over 65 years accessing general practice services over the last decade. Although people aged 65 years and over comprise 14% of the total population, this age demographic accounts for the largest proportion of general practitioner (GP)–patient encounters. Access to general practice is important for older Australians as the burden of chronic disease increases with age. A geographic information system, ArcGIS, was used to assess geographic access to general practice for older people residing in the regional Queensland towns of Mackay, Townsville and Cairns. Geographic units with high proportions of over 65-year-old people were spatially analysed in relation to proximity to geomapped general practices with a 2-km buffer zone. Modelling of changes in access was performed with the strategic location of a new general practice where gaps existed. Geographic access to general practice for the older population was poorest in Cairns despite a high population density. Addition of a single, strategically placed general practice in Cairns markedly improved access. Socioeconomic analysis suggested that general practices were appropriately located in areas of greatest need. Geographic information systems provide a means to map population characteristics against service locations to assist in strategic development and location of future health services.
Additional keywords: elderly, general practice, GIS.
References
Australian Bureau of Statistics (2011a) 2011 Census QuickStats Australia. (Australian Bureau of Statistics: Canberra) Available at http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/0?opendocument&navpos=220 [Verified 23 May 2014]Australian Bureau of Statistics (2011b) Australian Statistical Geography Standard (ASGS) Volume 1. Main structure and greater capital city statistical areas. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/1270.0.55.001Main%20Features1July%202011?opendocument&tabname=Summary&prodno=1270.0.55.001&issue=July%202011&num=&view= [Verified 23 May 2014]
Australian Bureau of Statistics (2011c) Statisical areas level 1 (SA1s): Statistical geography fact sheet. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/websitedbs/d3310114.nsf/4a256353001af3ed4b2562bb00121564/6b6e07234c98365aca25792d0010d730/$FILE/Statistical%20Area%20Level%201%20-%20Fact%20Sheet%20.pdf [Verified 23 May 2014]
Australian Bureau of Statistics (2011d) Census DataPacks: Queensland Statistical Area 1. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/websitedbs/censushome.nsf/home/datapacks?opendocument&navpos=250 [Verified 23 May 2014]
Australian Bureau of Statistics (2011e) Socio-economic indexes for areas. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa?opendocument&navpos=260 [Verified 23 May 2014]
Australian Bureau of Statistics (2011f) ESRI shapefile: digital boundary statistical area level 1. Australian Bureau of Statistics: Canberra. Available at http://www.abs.gov.au/websitedbs/censushome.nsf/home/datapacks?opendocument&navpos=250 [Verified 23 May 2014]
Australian Bureau of Statistics (2012) Australian health survey: health service usage and health related actions, 2011–12. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4364.0.55.002Main+Features12011-12?OpenDocument [Verified 30 April 2015]
Australian Bureau of Statistics (2014) 4102.0 Australian social trends, July 2013: Car Nation. (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features40July+2013#use [Verified 30 April 2015]
Australian Government Productivity Commission (2005) Australia’s health workforce: research report. (Australian Government Productivity Commission: Canberra) Available at http://www.pc.gov.au/inquiries/completed/health-workforce/report [Verified 30 April 2015]
Australian Institute of Health and Welfare (2014) Australia’s health 2014. Australia’s health series number 14. Catalogue number AUS 178. (AIHW: Canberra) Available at http://www.aihw.gov.au/publication-detail/?id=60129547205 [Verified 30 April 2015]
Aysola J, Bitton A, Zaslavsky A, Ayanian J (2013) Quality and equity of primary care with patient-centred medical homes: results from a national survey. Medical Care 51, 68–77.
| Quality and equity of primary care with patient-centred medical homes: results from a national survey.Crossref | GoogleScholarGoogle Scholar | 23047125PubMed |
Britt H, Harrison C, Miller G, Knox S (2008) Prevalence and patterns of multimorbidity in Australia. The Medical Journal of Australia 189, 72–77.
Britt H, Miller G, Henderson J, Bayram C, Valenti L, Harrison C, Pan Y, Wong C, Charles J, Chambers T, Gordon J, Pollack A (2014) A decade of Australian general practice activity 2004–05 to 2013–14. General practice series number 37. Sydney University Press, Sydney. Available at http://ses.library.usyd.edu.au/handle/2123/11883 [Verified 30 April 2015]
Campbell SM, Roland MO, Buetow SA (2000) Defining quality of care. Social Science & Medicine 51, 1611–1625.
| Defining quality of care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3crhtl2gsg%3D%3D&md5=a2755f56eeac86cba0e0d39d2ce4654aCAS |
Clark RA, Driscoll A, Nottage J, McLennan S, Coombe D, Bamford E, Wilkinson D, Stewart S (2007) Inequitable provision of optimal services for patients with chronic heart failure: a national geo-mapping study. The Medical Journal of Australia 186, 169–173.
Coffee N, Turner D, Clark R, Eckert K, Coombe D, Hugo G, van Gaans D, Wilkinson D, Stewart S, Tonkin A (2012) Measuring national accessibility to cardiac services using geographic information systems. Applied Geography 34, 445–455.
| Measuring national accessibility to cardiac services using geographic information systems.Crossref | GoogleScholarGoogle Scholar |
DePuccio M, Hoff T (2013) Medical home interventions and quality outcomes for older adults: a systematic review. Quality Management in Health Care 22, 327–340.
| Medical home interventions and quality outcomes for older adults: a systematic review.Crossref | GoogleScholarGoogle Scholar | 24088881PubMed |
Dulin M, Ludden T, Tapp H, Blackwell J, de Hernandez B, Smith H, Furuseth O (2010) Using Geographic Information Systems (GIS) to understand a community’s primary care needs. Journal of the American Board of Family Medicine 23, 13–21.
| Using Geographic Information Systems (GIS) to understand a community’s primary care needs.Crossref | GoogleScholarGoogle Scholar | 20051538PubMed |
Field K, Briggs D (2001) Socio-economic and locational determinants of accessibility and utilization of primary health-care. Health & Social Care in the Community 9, 294–308.
| Socio-economic and locational determinants of accessibility and utilization of primary health-care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrhtlSmuw%3D%3D&md5=835b3c6767db4bdd55e448fe415e7762CAS |
Harrison C, Britt H (2011) General practice – workforce gaps now and in 2020. Australian Family Physician 40, 12–15.
Health Workforce Australia (2012) Health workforce 2025: doctors, nurses and midwives – Volume 1. (Health Workforce Australia: Adelaide) Available at https://www.hwa.gov.au/our-work/build-capacity/australias-future-health-workforce-hw2025 [Verified 30 April 2015]
Jackson G, Powers B, Chatterjee R, Bettger J, Kemper A, Hasselblad V, Dolor R, Julian I, Heidenfelder B, Kendrick A, Gray R, Williams J (2013) The patient-centered medical home: a systematic review. Annals of Internal Medicine 158, 169–178.
| The patient-centered medical home: a systematic review.Crossref | GoogleScholarGoogle Scholar | 24779044PubMed |
Jin C, Cheng J, Lu Y, Huang Z, Cao F (2015) Spatial inequity in access to healthcare facilities at a county level in a developing country: a case study of Deqing County, Zhejiang, China. International Journal for Equity in Health 14, 67
| Spatial inequity in access to healthcare facilities at a county level in a developing country: a case study of Deqing County, Zhejiang, China.Crossref | GoogleScholarGoogle Scholar | 26286033PubMed |
Kruger E, Tennant M, George R (2011) Application of geographic information systems to the analysis of private dental practices distribution in Western Australia. Rural and Remote Health 11, 1736
Levesque J, Harris M, Russell G (2013) Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health 12, 18
| Patient-centred access to health care: conceptualising access at the interface of health systems and populations.Crossref | GoogleScholarGoogle Scholar | 23496984PubMed |
Luo W, Wang F (2003) Measure of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region. Environment and Planning – B. Planning & Design 30, 865–884.
| Measure of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region.Crossref | GoogleScholarGoogle Scholar |
MacKee N (2015) Medical home potential. MJA InSight, 8 June 2015. (Australasian Medical Publishing Co. Pty Ltd: Sydney, Australia) Available at https://www.mja.com.au/insight/2015/21/medical-home-potential [Verified 10 October 2015]
Mao L, Nekorchuk D (2013) Measuring spatial accessibility to healthcare for populations with multiple transportation modes. Health & Place 24, 115–122.
| Measuring spatial accessibility to healthcare for populations with multiple transportation modes.Crossref | GoogleScholarGoogle Scholar |
Masoodi M, Rahimzadeh M (2015) Measuring access to urban health services using Geographical Information System (GIS): a case study of health service management in Bandar Abbas, Iran. International Journal of Health Policy and Management 4, 439–445.
| Measuring access to urban health services using Geographical Information System (GIS): a case study of health service management in Bandar Abbas, Iran.Crossref | GoogleScholarGoogle Scholar | 26188808PubMed |
McGrail M (2012) Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements. International Journal of Health Geographics 11, 50
| Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements.Crossref | GoogleScholarGoogle Scholar | 23153335PubMed |
McGrail MR, Humphreys JS (2014) Measuring spatial accessibility to primary health care services: utilising dynamic catchment sizes. Applied Geography (Sevenoaks, England) 54, 182–188.
| Measuring spatial accessibility to primary health care services: utilising dynamic catchment sizes.Crossref | GoogleScholarGoogle Scholar |
McKernan S, Kuthy R, Momany E, McQuistan M, Hanley P, Jones M, Damiano P (2013) Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents. Journal of Public Health Dentistry 73, 56–64.
| Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents.Crossref | GoogleScholarGoogle Scholar | 23289856PubMed |
McKinnon B, Harper S, Kaufman JS, Abdullah M (2014) Distance to emergency obstetric services and early neonatal mortality in Ethiopia. Tropical Medicine & International Health 19, 780–790.
| Distance to emergency obstetric services and early neonatal mortality in Ethiopia.Crossref | GoogleScholarGoogle Scholar |
Moureaux C, Perelman J, Mendes da Costa E, Roch I, Annemans L, Heymans I, Closon M (2015) Impact of the Medical Home Model on the quality of primary care: the Belgian experience. Medical Care 53, 396–400.
| Impact of the Medical Home Model on the quality of primary care: the Belgian experience.Crossref | GoogleScholarGoogle Scholar | 25811631PubMed |
National Health Performance Authority (2015) Healthy communities: frequent GP attenders and their use of health services in 2012-2013. (NHPA: Sydney) Available at http://www.nhpa.gov.au/internet/nhpa/publishing.nsf/Content/Our-reports [Verified 10 October 2015]
Pink B (2011) ‘Technical paper Socio-Economic Indexes for Areas (SEIFA) 2033.0.55.001.’ (Australian Bureau of Statistics: Canberra)
Rodriguez R, Hotchkiss J, O’Hare A (2013) Geographic information systems and chronic kidney disease: racial disparities, rural residence and forecasting. Journal of Nephrology 26, 3–15.
| Geographic information systems and chronic kidney disease: racial disparities, rural residence and forecasting.Crossref | GoogleScholarGoogle Scholar | 23065915PubMed |
Roeger L, Reed R, Smith B (2010) Equity of access in the spatial distribution of GPs within an Australian metropolitan city. Australian Journal of Primary Health 16, 284–290.
| Equity of access in the spatial distribution of GPs within an Australian metropolitan city.Crossref | GoogleScholarGoogle Scholar | 21138695PubMed |
Rosenthal T (2008) The medical home: growing evidence to support a new approach to primary care. Journal of the American Board of Family Medicine 21, 427–440.
| The medical home: growing evidence to support a new approach to primary care.Crossref | GoogleScholarGoogle Scholar | 18772297PubMed |
Schneider A (2013) GPS Visualizer’s address locator. GPS Visualizer. Available at http://www.gpsvisualizer.com/geocoder/ [Verified 28 February 2014]
Starfield B, Shi L, Macinko J (2005) Contribution of primary care to health systems and health. The Milbank Quarterly 83, 457–502.
| Contribution of primary care to health systems and health.Crossref | GoogleScholarGoogle Scholar | 16202000PubMed |
Tennant M, Kruger E, Shiyha J (2013) Dentist-to-population and practice-to-population ratios: in a shortage environment with gross maldistribution what should rural and remote communities focus their attention on? Rural and Remote Health 13, 1–7.
World Health Organization (2008) The right to health: fact sheet number 31. (WHO: Geneva) Available at http://www.who.int/hhr/activities/Right_to_Health_factsheet31.pdf?ua=1 [Verified 10 October 2015]
Yao J, Murray A, Agadjanian V (2013) A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Social Science & Medicine 96, 60–68.
| A geographical perspective on access to sexual and reproductive health care for women in rural Africa.Crossref | GoogleScholarGoogle Scholar |
Zaman S, Cox J, Enwere G, Bottomley C, Greenwood B, Cutts F (2014) The effect of distance on observed mortality, childhood pneumonia and vaccine efficacy in rural Gambia. Epidemiology and Infection 142, 2491–2500.
| The effect of distance on observed mortality, childhood pneumonia and vaccine efficacy in rural Gambia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2cvnsFOqtA%3D%3D&md5=57cb9cb69fc0ab15c74eb9ee450ca5d0CAS | 24565180PubMed |
