Blanco-Cazeaux Iñaki
Department of Public Health, University of Bordeaux, 146 Léo Saignat Street, 33076, Bordeaux, France.
SSM Popul Health. 2022 Sep 26;19:101240. doi: 10.1016/j.ssmph.2022.101240. eCollection 2022 Sep.
For several years now, the socio-political context in France has widened the territorial divide between metropolitan France and peripheral France. Access to healthcare is part of this divide, which harms small and medium-sized towns as well as rural fringes. This article focuses on these geographic dynamics in access to healthcare, with a focus on self-employed general practitioners (GPs), who are essential links in the care pathway as referring physicians.
This paper uses data from French public statistics from 2007 to 2017 to build spatial panels and to highlight the territorial factors that explain the dynamics of the locations of GPs.
Over the period under review, the density of GPs has decreased and territorial disparity has increased. There is no trend towards a worsening of this isolation of either the periphery or deprived cantons with regard to the density of GPs in these areas. However, we note a clear trend towards the grouping together of different types of care within cantons, leading to a tendency towards the polarization of the healthcare supply in the territories of mainland France, which implies another type of geographical difficulty.
The increase in territorial disparities in accessibility to GPs does not really seem to correspond to the classical divides in France, but rather raises the issue of intra-metropolis and intra-periphery disparities.
多年来，法国的社会政治环境加剧了法国本土与外围地区之间的地域差距。获得医疗服务就是这种差距的一部分，它对中小城镇以及农村边缘地区造成了损害。本文聚焦于获得医疗服务方面的这些地理动态，重点关注个体开业全科医生，他们作为转诊医生是医疗途径中的关键环节。
本文使用2007年至2017年法国公共统计数据来构建空间面板，并突出解释全科医生分布动态的地域因素。
在审查期间，全科医生的密度下降，地域差距加大。在这些地区，无论是外围地区还是贫困行政区，全科医生密度方面不存在这种隔离加剧的趋势。然而，我们注意到一个明显的趋势，即不同类型的医疗服务在行政区内趋于集中，导致法国本土地区医疗服务供应出现两极分化趋势，这意味着另一种地理难题。
获得全科医生服务的地域差距增加似乎并不真正符合法国传统的划分，而是引发了大都市内部和外围地区内部差距的问题。
