GIS Research Centre, Wales Institute of Social and Economic Research, Data and Methods (WISERD), University of South Wales, Pontypridd, UK.
Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Health Soc Care Community. 2019 Jul;27(4):1074-1084. doi: 10.1111/hsc.12724. Epub 2019 Feb 5.
There are ongoing policy concerns surrounding the difficulty in obtaining timely appointments to primary healthcare services and the potential impact on, for example, attendance at accident and emergency services and potential health outcomes. Using the case study of potential access to primary healthcare services in Wales, Geographic Information System (GIS)-based tools that permit a consideration of population-to-provider ratios over space are used to examine variations in geographical accessibility to general practitioner (GP) surgeries offering appointment times outside of 'core' operating hours. Correlation analysis is used to explore the association of accessibility scores with potential demand for such services using UK Population Census data. Unlike the situation in England, there is a tendency for accessibility to those surgeries offering 'extended' hours of appointment times to be better for more deprived census areas in Wales. However, accessibility to surgeries offering appointments in the evening was associated with lower levels of working age population classed as 'economically active'; that is, those who could be targeted beneficiaries of policies geared towards 'extended' appointment hours provision. Such models have the potential to identify spatial mismatches of different facets of primary healthcare, such as 'extended' hours provision available at GP surgeries, and are worthy of further investigation, especially in relation to policies targeted at particular demographic groups.
目前，人们对以下问题存在持续的政策担忧：难以及时获得初级保健服务，以及这可能对例如事故和紧急服务的就诊情况和潜在健康结果产生的影响。以威尔士初级保健服务潜在可及性的案例研究为例，利用基于地理信息系统（GIS）的工具，可以考虑空间上的人口与提供者比例，从而检查在非“核心”营业时间提供预约服务的全科医生（GP）手术的地理可及性的差异。利用英国人口普查数据，采用相关分析来探索可及性评分与对这些服务的潜在需求之间的关联。与英格兰的情况不同，威尔士那些提供“延长”预约时间服务的手术的可及性对于贫困程度更高的普查区更好。然而，提供晚间预约服务的手术与被归类为“经济活跃”的劳动年龄人口比例较低有关；也就是说，这些人可能是针对“延长”预约时间服务提供的政策的目标受益人群。这些模型有可能识别初级保健不同方面的空间不匹配情况，例如全科医生手术中提供的“延长”服务时间，值得进一步研究，特别是针对特定人群的政策。
