Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care

Abstract 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 trave...

Full description

Bibliographic Details
Main Authors: Ulrike Stentzel, Jeanette Bahr, Daniel Fredrich, Jens Piegsa, Wolfgang Hoffmann, Neeltje van den Berg
Format: Article
Language:English
Published: BMC 2018-05-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-018-3143-5
_version_ 1818285814152429568
author Ulrike Stentzel
Jeanette Bahr
Daniel Fredrich
Jens Piegsa
Wolfgang Hoffmann
Neeltje van den Berg
author_facet Ulrike Stentzel
Jeanette Bahr
Daniel Fredrich
Jens Piegsa
Wolfgang Hoffmann
Neeltje van den Berg
author_sort Ulrike Stentzel
collection DOAJ
description Abstract 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.
first_indexed 2024-12-13T01:14:40Z
format Article
id doaj.art-059515a0f95c4dd4ae537a10813a7509
institution Directory Open Access Journal
issn 1472-6963
language English
last_indexed 2024-12-13T01:14:40Z
publishDate 2018-05-01
publisher BMC
record_format Article
series BMC Health Services Research
spelling doaj.art-059515a0f95c4dd4ae537a10813a75092022-12-22T00:04:22ZengBMCBMC Health Services Research1472-69632018-05-0118111110.1186/s12913-018-3143-5Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general careUlrike Stentzel0Jeanette Bahr1Daniel Fredrich2Jens Piegsa3Wolfgang Hoffmann4Neeltje van den Berg5Institute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldAbstract 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.http://link.springer.com/article/10.1186/s12913-018-3143-5AccessibilityUtilizationGPGynecologistGIS
spellingShingle Ulrike Stentzel
Jeanette Bahr
Daniel Fredrich
Jens Piegsa
Wolfgang Hoffmann
Neeltje van den Berg
Is there an association between spatial accessibility of outpatient care and utilization? Analysis of gynecological and general care
BMC Health Services Research
Accessibility
Utilization
GP
Gynecologist
GIS
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 Accessibility
Utilization
GP
Gynecologist
GIS
url http://link.springer.com/article/10.1186/s12913-018-3143-5
work_keys_str_mv AT ulrikestentzel isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare
AT jeanettebahr isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare
AT danielfredrich isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare
AT jenspiegsa isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare
AT wolfganghoffmann isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare
AT neeltjevandenberg isthereanassociationbetweenspatialaccessibilityofoutpatientcareandutilizationanalysisofgynecologicalandgeneralcare