Madill Rebecca, Badland Hannah, Mavoa Suzanne, Giles-Corti Billie
Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie St, Parkville, VIC, 3052, Australia.
Healthy Liveable Cities Group, Centre for Urban Research, RMIT University, Building 15, Level 3, Room 12, Office 3, 124 La Trobe Street, Melbourne, VIC, 3000, Australia.
BMC Health Serv Res. 2018 Apr 13;18(1):286. doi: 10.1186/s12913-018-3079-9.
Melbourne, Australia is experiencing rapid population growth, with much of this occurring in metropolitan outer suburban areas, also known as urban growth areas. Currently little is known about differences in travel times when using private and public transport to access primary and secondary services across Melbourne's urban growth areas. Plan Melbourne Refresh, a recent strategic land use document has called for a 20 min city, which is where essential services including primary health care, can be accessed within a 20 min journey. Type 2 diabetes mellitus (T2DM) is a major chronic condition in Australia, with some of Melbourne's growth areas having some of the highest prevalence across Australia. This study explores travel times to diabetic health care services for populations residing in inner, middle and outer suburbs of metropolitan Melbourne.
Geographic information systems (GIS) software were used to map the location of selected diabetic primary and secondary health care service providers across metropolitan inner, middle, outer established, outer urban growth and outer fringe areas of Melbourne. An origin-destination matrix was used to estimate travel distances from point of origin (using a total of approximately 50,000 synthetic residential addresses) to the closest type of each diabetic health care service provider (destinations) across Melbourne. ArcGIS was used to estimate travel times for private transport and public transport; comparisons were made by area.
Our study indicated increased travel times to diabetic health services for people living in Melbourne's outer growth and outer fringe areas compared with the rest of Melbourne (inner, middle and outer established). Compared with those living in inner city areas, the median time spent travelling to diabetic services was between 2.46 and 23.24 min (private motor vehicle) and 12.01 and 43.15 min (public transport) longer for those living in outer suburban areas. Irrespective of travel mode used, results indicate that those living in inner and middle suburbs of Melbourne have shorter travel times to access diabetic health services, compared with those living in outer areas of Melbourne. Private motor vehicle travel times were approximately 4 to 5 times faster than public transport modes to access diabetic health services in all areas.
Those living in new urban growth communities spend considerably more time travelling to access diabetic health services - particularly specialists - than those living in established areas across Melbourne.
澳大利亚墨尔本人口增长迅速，其中大部分增长发生在大都市的外郊区，即所谓的城市增长区。目前，对于在墨尔本城市增长区使用私人交通和公共交通前往初级和二级服务机构的出行时间差异知之甚少。最近的一份战略土地利用文件《墨尔本规划更新》呼吁建设“20分钟城市”，即在20分钟的行程内能够获得包括初级医疗保健在内的基本服务。2型糖尿病（T2DM）是澳大利亚的一种主要慢性病，墨尔本的一些增长区在澳大利亚的患病率最高。本研究探讨了墨尔本大都市内城、中城和外城郊区居民前往糖尿病医疗服务机构的出行时间。
使用地理信息系统（GIS）软件绘制墨尔本大都市内城、中城、外城已建成区、外城增长区和外边缘区选定的糖尿病初级和二级医疗服务提供者的位置。使用起讫点矩阵来估计从起点（总共使用约50,000个合成住宅地址）到墨尔本各地每种糖尿病医疗服务提供者（目的地）最近类型地点之间的出行距离。使用ArcGIS估计私人交通和公共交通的出行时间；并按区域进行比较。
我们的研究表明，与墨尔本其他地区（内城、中城和外城已建成区）相比，居住在墨尔本外城增长区和外边缘区的居民前往糖尿病医疗服务机构的出行时间增加。与居住在内城区的居民相比，居住在外郊区的居民前往糖尿病服务机构花费的中位时间在私人机动车出行时要长2.46至23.24分钟，在公共交通出行时要长12.01至43.15分钟。无论使用何种出行方式，结果表明，与居住在墨尔本外区居民相比,居住在墨尔本内城和中城郊区的居民前往糖尿病医疗服务机构花费的出行时间较短在所有区域,私人机动车前往糖尿病医疗服务机构花费的出行时间比公共交通方式快约4至5倍。
与居住在墨尔本已建成区的居民相比，居住在新城市增长社区居民前往糖尿病医疗服务机构，尤其是专科医生服务机构，花费的出行时间要长得多。
