Determining geographic accessibility of family physician and nurse practitioner services in relation to the distribution of seniors within two Canadian Prairie Provinces

Shah, Tayyab; Milosavljevic, Stephan; Bath, Brenna

doi:10.1016/j.socscimed.2017.10.019

Cited by 42 publications

(49 citation statements)

References 43 publications

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“…These findings suggest a discrepancy between the distribution of PCPs and the residence of the senior population in the region. Previous research has observed similar patterns of mismatch between the supply of FPs and clusters of seniors (Vogt ; Shah et al ). However, our results highlight a slightly more pronounced trend that most of the areas with low accessibility to PCPs and a higher share of the senior population were located close to large and medium population centres.…”

Section: Discussionmentioning

confidence: 52%

“…The Canada Health Act sets out the conditions for the provincial and territorial governments to provide reasonable access to medically necessary hospital and doctor services, including primary health care (Canada ). Despite having a universal health care system, many Canadians still experience difficulty in accessing primary care services (Reid et al ; Paez et al ; Crooks and Schuurman ; Shah et al ; Kaur Khakh et al ). A retrospective analysis of administrative health data in Ontario highlights that “just over two‐thirds of primary care physicians provided comprehensive care in 2014/15, which indicates that traditional estimates of the primary physician workforce may be too high” (Schultz and Glazier , E856).…”

Section: Introductionmentioning

confidence: 99%

“…Contextual factors (e.g., place of residence, distance to facilities, and transport infrastructure) can serve as barriers or facilitators to accessing health care resources (Chan et al 2006;Cinnamon et al 2008;McDonald et al 2017;Wang et al 2017), which are in turn associated with health outcomes (Subramanian 2004;Holtz et al 2014). Health care accessibility is inversely associated with distance or travel time and is sensitive to where people are located within a large metropolitan area (Guagliardo et al 2004;Charreire and Combier 2009;Bauer et al 2016;Shah et al 2016;Gilliland et al 2019) and/or across the urban-rural continuum (Cinnamon et al 2008;McGrail and Humphreys 2015;McDonald et al 2017;Shah et al 2017). Even within urban areas, transportation is one of the most commonly cited barriers to primary care access (McColl et al 2015;South East Local Health Integration Network 2015).…”

mentioning

confidence: 99%

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Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Shah

Clark

Seabrook

et al. 2019

Canadian Geographies / Géographies canadiennes

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This research examines geographical accessibility to primary care providers (PCPs) across urban and rural areas of Southwestern Ontario and examines variations in the distribution of PCPs in relation to the senior population (aged 65 years and older). Information about PCP practices was provided by the HealthForceOntario Marketing and Recruitment Agency. Population data were obtained from the 2016 Census of Canada. To calculate scores for accessibility to PCPs (i.e., PCPs/10,000 population), we applied the enhanced 2‐step floating catchment area method with distance decay effect within a global service catchment of 30‐minute drive time. A geospatial mapping approach revealed disparities in the distribution of PCPs with a pattern of higher spatial accessibility in or around major urban areas in Southwestern Ontario. Comparative analyses were performed in association with the seniors’ population to identify how accessibility scores were mismatched with the population needs. The outcome of this study will assist researchers and health service planners to better understand the distribution of existing PCPs to address inequalities, particularly in rural areas.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Shah

Clark

Seabrook

et al. 2019

Canadian Geographies / Géographies canadiennes

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“…Reflecting the potential impact of NPPs on access to primary care, the Health Resources and Services Administration (HRSA) suggests that NPPs be included in the determination of shortage areas for primary care . Studies outside the United States have demonstrated the important contribution of NPPs to primary care accessibility . However, to our knowledge, the effects of NPPs on the spatial accessibility of primary care have not been modeled at the local level in the United States.…”

Section: Introductionmentioning

confidence: 99%

Impact of nonphysician providers on spatial accessibility to primary care in Iowa

Young

Gruca

Nelson

2020

Health Services Research

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Objective To assess the impact of nonphysician providers on measures of spatial access to primary care in Iowa, a state where physician assistants and advanced practice registered nurses are considered primary care providers. Data Sources 2017 Iowa Health Professions Inventory (Carver College of Medicine), and minor civil division (MCD) level population data for Iowa from the American Community Survey. Study Design We used a constrained optimization model to probabilistically allocate patient populations to nearby (within a 30‐minute drive) primary care providers. We compared the results (across 10 000 scenarios) using only primary care physicians with those including nonphysician providers (NPPs). We analyze results by rurality and compare findings with current health professional shortage areas. Data Collection/Extraction Methods Physicians and NPPs practicing in primary care in 2017 were extracted from the Iowa Health Professions Inventory. Principal Findings Considering only primary care physicians, the average unallocated population for primary care was 222 109 (7 percent of Iowa's population). Most of the unallocated population (86 percent) was in rural areas with low population density (< 50/square mile). The addition of NPPs to the primary care workforce reduced unallocated population by 65 percent to 78 252 (2.5 percent of Iowa's population). Despite the majority of NPPs being located in urban areas, most of the improvement in spatial accessibility (78 percent) is associated with sparsely populated rural areas. Conclusions The inclusion of nonphysician providers greatly reduces but does not eliminate all areas of inadequate spatial access to primary care.

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“…A análise espacial permite estudar aspectos geográficos, por exemplo, na ABS, ao trazer novas informações para a discussão de equidade, por meio do acesso geográfico e das diferenças no uso segundo aspectos socioeconômicos 18 . Além disso, outros estudos demonstram a importância da identificação de áreas geográficas que necessitam de serviços de ABS, com foco em grupos de profissionais de saúde 19 , ou para analisar potenciais desigualdades na mobilização de recursos da ABS para adequação do financiamento ao que a população necessitar 20 .…”

Section: Introductionunclassified

Análise espacial da qualidade da Atenção Básica em Saúde no Brasil

et al. 2018

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RESUMO Este artigo teve como objetivo analisar a distribuição espacial das equipes de Atenção Básica em Saúde (ABS) avaliadas pelo Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB) segundo as categorias de desempenho para certificação no Programa. Realizou-se uma caracterização da distribuição espacial dos municípios mediante a avaliação do PMAQ-AB, bem como a identificação da presença de padrões espaciais a partir de um indicador de correlação espacial para avaliar o grau de influência do espaço para a certificação das equipes de ABS. Observou-se presença de padrões de natureza espacial em relação à qualidade da ABS. Municípios com valor baixo no indicador cujos vizinhos também apresentam nível baixo foram encontrados em boa parte dos estados do Acre, do Amazonas, de Roraima e do Amapá, bem como no Rio de Janeiro e no Espírito Santo. Foram observados clusters de padrão alto-alto em municípios de São Paulo, Minas Gerais e Rio Grande do Sul, com destaque para Santa Catarina. A identificação de padrões espaciais de qualidade da ABS pode representar um recurso valioso para o aperfeiçoamento do PMAQ-AB. Com isso, é possível desenvolver análises que incorporem variáveis com potencial explicativo para os padrões espaciais de qualidade de ABS encontrados em municípios brasileiros.PALAVRAS-CHAVE Atenção Primária à Saúde. Análise espacial. Brasil. ABSTRACT This article aims to analyze the spatial distribution of the Primary Health Care (ABS) teams evaluated by the National Program for Access and Quality Improvement in Primary HealthCare (PMAQ-AB) according to the categories of performance for certification in the Program. A spatial distribution profile of the municipalities according to the PMAQ-AB evaluation was carried out, as well as the identification of spatial patterns from a spatial correlation indicator to evaluate the degree of space influence for the certification of ABS teams. It was found presence of spatial patterns in relation to ABS quality. Municipalities with low values in the indicator, whose neighbors are also low, are found in most of the states of Acre, Amazonas, Roraima and Amapá, as well as in Rio de Janeiro and Espírito Santo. High-high standard clusters were observed in the municipalities of São Paulo, Minas Gerais and Rio Grande do Sul, especially in Santa Catarina. The identification of the spatial quality standards of ABS can be a valuable resource for the further PMAQ-AB development. It will be possible, thus, to develop analyses that incorporate variables with explanatory potential for the spatial patterns of ABS quality found in Brazilian municipalities.

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Determining geographic accessibility of family physician and nurse practitioner services in relation to the distribution of seniors within two Canadian Prairie Provinces

Cited by 42 publications

References 43 publications

Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Impact of nonphysician providers on spatial accessibility to primary care in Iowa

Análise espacial da qualidade da Atenção Básica em Saúde no Brasil

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