Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

中文翻译：

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使用 GIS 和感知距离来了解低收入城市社区医疗保健的不平等地理

地理学家在公共卫生研究中发挥着重要作用，尤其是在了解医疗保健可及性、利用和个人医疗保健体验方面。大多数可访问性研究都受益于地理信息系统 (GIS) 的日益复杂化。一些研究已经通过半结构化的深度访谈得到加强，以了解人们在获得医疗保健服务时的个人经历。然而，很少有可达性研究明确利用个人深度访谈数据来构建新的 GIS 可达性措施。使用混合方法，包括 GIS 分析和来自半结构化深度访谈的个人数据，我们提供了满意度调整距离，作为在 GIS 中概念化可访问性的新方法。根据在哥伦布主要低收入社区的实地调查，俄亥俄州（美国），我们发现许多居民认为邻里医疗机构提供的医疗服务质量较差，这表明他们在尝试使用高质量医疗机构时感知距离增加。满意度调整距离衡量标准解释了一些居民在低收入城市社区寻求高质量医疗保健服务时的感知距离。在超越传统 GIS 并以这种方式重新定义可访问性的过程中，我们更真实地描绘了低收入城市居民在尝试使用高质量医疗设施时所面临的问题。这项工作对概念化医疗保健可及性具有理论意义，推进了混合方法文献，并主张在城市社区中更公平地分配高质量的医疗保健。我们发现许多居民认为邻里医疗机构提供的医疗服务质量较差，这表明他们在尝试使用高质量医疗机构时感知距离有所增加。满意度调整距离衡量标准解释了一些居民在低收入城市社区寻求高质量医疗保健服务时的感知距离。在超越传统 GIS 并以这种方式重新定义可访问性的过程中，我们更真实地描绘了低收入城市居民在尝试使用高质量医疗设施时所面临的问题。这项工作对概念化医疗保健可及性具有理论意义，推进了混合方法文献，并主张在城市社区中更公平地分配高质量的医疗保健。我们发现许多居民认为邻里医疗机构提供的医疗服务质量较差，这表明他们在尝试使用高质量医疗机构时感知距离有所增加。满意度调整距离衡量标准解释了一些居民在低收入城市社区寻求高质量医疗保健服务时的感知距离。在超越传统 GIS 并以这种方式重新定义可访问性的过程中，我们更真实地描绘了低收入城市居民在尝试使用高质量医疗设施时所面临的问题。这项工作对概念化医疗保健可及性具有理论意义，推进了混合方法文献，并主张在城市社区中更公平地分配高质量的医疗保健。