In:
International Journal of Epidemiology, Oxford University Press (OUP), Vol. 50, No. Supplement_1 ( 2021-09-01)
Abstract:
Populations with high needs often have poor health care access. Defining need is challenging, with no agreed-upon indicator of health need for primary care based spatial equity research in New Zealand. We examined seven potential indicators and tested for evidence of the Inverse Care Law in the Waikato region. Methods Indicators were identified through a systematic literature review and scored according to ten selection criteria. Indicators were mapped and analysed using GIS. Spearman’s correlations were calculated between indicators, and clusters of high need identified through spatial autocorrelation. The impact of incorporating indicator-based-weightings into an accessibility model was tested using ANOVA and Spearman’s correlations. GP service spatial equity was assessed by comparing clusters of access and need, and quantified through the Gini coefficient. Results While smoking rates met the most selection criteria, ambulatory sensitive hospitalisation (ASH) rates were significantly correlated with all indicators. Health needs were significantly clustered, but incorporating indicator weightings into the spatial accessibility analysis did not impact accessibility scores. A misalignment of access and need, and Gini coefficient of 0.281 suggests that services are not equitably distributed. Conclusions ASH rates seem a robust indicator of health need. However, data access issues may restrict their use. High need clusters vary spatially according to the indicator used. Key messages GIS techniques can identify ‘hot-spots’ of need, but these can be masked in accessibility models. Indicators should be carefully selected according to the research question.
Type of Medium:
Online Resource
ISSN:
0300-5771
,
1464-3685
DOI:
10.1093/ije/dyab168.709
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2021
detail.hit.zdb_id:
1494592-7
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