Posted on August 5th, 2014

Back to School – Hospital Travel Time

There has been an ongoing debate in this country about public health and access to medical treatment. Who is responsible, and what lengths should the populous and government go to provide insurance and care for its constituents? Well, we are not the only country to have issues with public health and its various trappings; and though different countries have different issues, it always seems there is a touch of social justice associated with the dialog.

Population distribution from a 1997 patient register.
Main bus routes in East Anglia, fall of 1997.
Estimated average travel time by car to nearest general practioner.

The National Health Service in the UK has an ongoing concern with access; making sure that those who need care can get it, and efficiently at that. As is the case anywhere, health care services are often clustered in specific areas, thus making those in closest proximity the most likely to get the treatment they need. Also of concern is that if people don’t engage in the use of general care, they are obviously far less likely to receive secondary or tertiary care; and this could not only be impactful on an individual’s health, but also on the health care system that provides the ultimate service.

More than 20% of the population in Britain lives in rural areas, and researchers at the University of East Anglia in Norwich set out to use GIS to map the distribution of general practitioner care practices in relation to population centers and rural communities. Using records from over 2 million patients, the authors looked at 1,274 parishes and 99 wards within the study area. Other data that was integral to the study included road data for the classifications of thoroughfares (including dual-carriage and single-carriage routes), as well as the speed limits on them. Further, bus availability and routes were included to consider accessibility for those without their own transportation.

The researchers used ArcGIS to examine digitized road networks, which showed intersections of thoroughfares, and then to generate discrete transit nodes. These nodes typically indicated where the types of road changed from one to another. To calculate distances of travel, each general practitioner was assigned to the nearest node on its network. The maximum preferred distance traveled was set at 5,000 meters. Due to the distant rural addresses of many of those in the study region, some as far as 600 meters out from the nearest node, the use of postal codes was employed to further dissect the study area.

The authors concluded that the area of study was relatively well-served. Nearly 90% of people within the region lived no more than a 10 minute drive from the nearest health center. For 5% of the population, the drive exceeded 10 minutes and there were no adequate bussing options; and this accounted for nearly 115,000 residents. They did find, however, that where public transportation was of greatest need for obtaining health care, the needs were frequently met. The takeaway for the authors was the surprising fact that important information for gauging people’s health issues and needs was difficult to come by. They were hopeful that this study would showcase the need for a more organized and deliberate system for assessing future health care access needs.

Justin Harmon
Staff Writer

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