Department of Geography, University of Leicester, Leicester, LE1 7RH, UK.
Int J Health Geogr. 2011 Jul 25;10:44. doi: 10.1186/1476-072X-10-44.
This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility.
Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results.
Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not.
Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned.
本文分析了公众对全科医生 (GP) 诊所和医院的可及性看法与健康状况、汽车拥有情况和地理距离之间的关系。在此过程中，探讨了与设施可及性相关的不同维度。
通过态度调查收集了有关获取卫生服务的困难、受访者健康状况和汽车拥有情况的数据。使用 GIS 为每个受访者计算到最近服务的道路距离。使用逻辑广义线性模型将困难与地理距离、健康状况和汽车拥有情况相关联。使用地理加权回归 (GWR) 探索结果的空间非平稳性。
发现受访者的长期疾病、报告的健康状况不佳和非汽车拥有情况是影响获得全科医生和医院服务的困难的重要预测因素。地理距离不是获得医院服务困难的重要预测因素，但对全科医生来说是重要预测因素。GWR 确定了这些全局关系的空间（局部）变化，表明了独立变量的预测强度高于或低于全局趋势的位置。健康状况不佳和非汽车拥有情况对获取卫生服务困难的影响在研究区域内存在空间差异，而地理距离的影响则没有。
发现获得不同卫生设施的困难与健康状况和汽车拥有情况显著相关，而地理距离的影响取决于所涉及的服务。GWR 显示了这些关系在研究区域内的变化情况。本研究表明，可及性的概念是一个多维概念，其组成根据所考虑的设施以及个人的健康和社会经济状况而在不同地点有所不同。
