Garza-Elizondo María Eugenia, Salinas-Martínez Ana María, Núñez-Rocha Georgina Mayela, Villarreal Ríos Enrique, Vásquez-Treviño María Guadalupe, Vásquez-Salazar María Guadalupe
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, México.
Rev Med Chil. 2008 Dec;136(12):1574-81. Epub 2009 Mar 23.
The accessibility to health centers is a limitation to the use of preventive and curative health centers.
To assess geographic accessibility using a parameter that integrates information about the use of preventive services and travelling time from home to the health center.
We analyzed target geographical areas of 10 community centers located at the Northeast of Mexico. A survey was conducted to collect information about the utilization of preventive services for detection of diabetes and hypertension within last year and in women, detection of cervical and breast cancer. The time required to travel between the health center and the farthest location point at every neighborhood of each geographic area, using public or private transportation, was calculated. Health service use and transportation time were condensed in a single parameter, called geographic accessibility index. Data was normalized using z scores.
Three geographical areas denominated 7, 8 and 10 had the lowest detection rates of chronic diseases, with values ranging from 45% to 48%. By car, area number 3 had the longest travelling time, corresponding to 14 minutes. The longest travelling times by public transportation were detected in areas 1 and 3, corresponding to 27 and 29 minutes, respectively The geographic accessibility index showed that the least favorable z scores travelling by car corresponded to areas 6 and 10 and, when travelling on public transportation, to areas 8 and 10.
The geographic accessibility index identified areas that required improvements in accessibility.
卫生中心的可达性是限制预防性和治疗性卫生中心使用的一个因素。
使用一个整合了预防服务使用信息和从家到卫生中心的出行时间的参数来评估地理可达性。
我们分析了位于墨西哥东北部的10个社区中心的目标地理区域。进行了一项调查，以收集有关去年糖尿病和高血压预防服务利用情况以及女性宫颈癌和乳腺癌检测情况的信息。计算了使用公共或私人交通工具在卫生中心与每个地理区域的每个社区最远地点之间出行所需的时间。卫生服务使用情况和交通时间被浓缩为一个单一参数，称为地理可达性指数。数据使用z分数进行标准化。
编号为7、8和10的三个地理区域慢性病检测率最低，值在45%至48%之间。乘坐汽车时，3号区域出行时间最长，为14分钟。乘坐公共交通工具时，1号和3号区域出行时间最长，分别为27分钟和29分钟。地理可达性指数显示，乘坐汽车时最不利的z分数对应于6号和10号区域，乘坐公共交通工具时对应于8号和10号区域。
地理可达性指数确定了需要改善可达性的区域。
