Rosemary Hiscock1, Jamie Pearce, Tony Blakely, Karen Witten. 1. GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand. rosemary.hiscock@canterbury.ac.nz
Abstract
OBJECTIVE: To explore whether travel time access to the nearest general practitioner (GP) surgery (which is equivalent to U.S. primary care physician [PCP] office) and pharmacy predicts individual-level health service utilization and satisfaction. DATA SOURCES: GP and pharmacy addresses were obtained from the New Zealand Ministry of Health in 2003 and merged with a geographic boundaries data set. Travel times derived from these data were appended to the 2002/03 New Zealand Health Survey (N=12,529). STUDY DESIGN: Multilevel logistic regression was used to model the relationship between travel time access and five health service outcomes: GP consultation, blood pressure test, cholesterol test, visit to pharmacy, and satisfaction with latest GP consultation. DATA COLLECTION/EXTRACTION: Travel times between each census meshblock centroid and the nearest GP and pharmacy were calculated using Geographical Information System. PRINCIPAL FINDINGS: When travel times were long, blood pressure tests were less likely in urban areas (odds ratio [OR] 0.75 [0.59-0.97]), GP consultations were less likely in rural centers (OR 0.42 [0.22-0.78]) and pharmacy visits were less likely in highly rural areas (OR 0.36 [0.13-0.99]). There was some evidence of lower utilization in rural areas. CONCLUSIONS: Locational access to GP surgeries and pharmacies appears to sometimes be associated with health service use but not satisfaction.
OBJECTIVE: To explore whether travel time access to the nearest general practitioner (GP) surgery (which is equivalent to U.S. primary care physician [PCP] office) and pharmacy predicts individual-level health service utilization and satisfaction. DATA SOURCES: GP and pharmacy addresses were obtained from the New Zealand Ministry of Health in 2003 and merged with a geographic boundaries data set. Travel times derived from these data were appended to the 2002/03 New Zealand Health Survey (N=12,529). STUDY DESIGN: Multilevel logistic regression was used to model the relationship between travel time access and five health service outcomes: GP consultation, blood pressure test, cholesterol test, visit to pharmacy, and satisfaction with latest GP consultation. DATA COLLECTION/EXTRACTION: Travel times between each census meshblock centroid and the nearest GP and pharmacy were calculated using Geographical Information System. PRINCIPAL FINDINGS: When travel times were long, blood pressure tests were less likely in urban areas (odds ratio [OR] 0.75 [0.59-0.97]), GP consultations were less likely in rural centers (OR 0.42 [0.22-0.78]) and pharmacy visits were less likely in highly rural areas (OR 0.36 [0.13-0.99]). There was some evidence of lower utilization in rural areas. CONCLUSIONS: Locational access to GP surgeries and pharmacies appears to sometimes be associated with health service use but not satisfaction.
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