The use of a geographical information system for hospital catchment area research in Natal/KwaZulu.

We use a computerised geographical information system (GIS) to study the population per bed ratios and the implications of open access to the private and the formerly white hospital services in Natal. The advantages of the GIS method over the more usual administrative boundary-based beds per capita ratios are discussed. While the latter method would suggest that hospital bed resources in the province are racially unequal but nevertheless adequate (264 people per general and referral bed for the whole population, 195 for whites and 275 for blacks) the GIS analysis reveals widespread inadequacy, worse for blacks. Of the estimated hospital catchment areas half have more than 275 black people per general and referral bed, and half of these have more than 550 black people per bed. One-third of the catchment areas estimated for whites have ratios above 275 people per bed, and one half of these are also above 550 people per bed. The GIS analysis shows that open access to beds previously reserved for whites will make no difference to rural blacks, and almost none to urban blacks, because there were relatively few such beds, and they were concentrated in the cities. For the same reasons, the opening of private hospital beds to all patients would not significantly alleviate the apparent bed shortages in priority areas. By contrast, people in these priority areas would gain significantly improved access to general hospital care if selected chronic disease and industrial hospitals were upgraded to provide general hospital services.(ABSTRACT TRUNCATED AT 250 WORDS)