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Disparities in Geographical Access to Hospitals in Portugal
ISPRS International Journal of Geo-Information ( IF 3.4 ) Pub Date : 2020-09-29 , DOI: 10.3390/ijgi9100567
Claudia Costa , José António Tenedório , Paula Santana

Geographical accessibility to health care services is widely accepted as relevant to improve population health. However, measuring it is very complex, mainly when applied at administrative levels that go beyond the small-area level. This is the case in Portugal, where the municipality is the administrative level that is most appropriate for implementing policies to improve the access to those services. The aim of this paper is to assess whether inequalities in terms of access to a hospital in Portugal have improved over the last 20 years. A population-weighted driving time was applied using the census tract population, the roads network, the reference hospitals’ catchment area and the municipality boundaries. The results show that municipalities are 25 min away from the hospital—3 min less than in 1991—and that there is an association with premature mortality, elderly population and population density. However, disparities between municipalities are still huge. Municipalities with higher rates of older populations, isolated communities or those located closer to the border with Spain face harder challenges and require greater attention from local administration. Since municipalities now have responsibilities for health, it is important they implement interventions at the local level to tackle disparities impacting access to healthcare.

中文翻译:

葡萄牙在地域可及性方面的差异

地理上可获得医疗服务的机会被广泛认为与改善人口健康有关。但是,测量它非常复杂,主要是在超出小型区域级别的管理级别应用时。葡萄牙就是这种情况,自治市是最适合实施旨在改善获得这些服务机会的政策的行政级别。本文的目的是评估在过去20年中,在葡萄牙获得医院方面的不平等状况是否有所改善。使用人口普查区人口,道路网络,参考医院的服务区域和市镇边界来应用人口加权的行驶时间。结果表明,市政当局距离医院只有25分钟的路程,比1991年减少了3分钟,而且与过早死亡,老年人口和人口密度有关。但是,市政当局之间的差距仍然很大。人口老龄化率较高的城市,偏远社区或与西班牙边境较近的城市面临更严峻的挑战,需要地方行政部门给予更多关注。由于市政当局现在对健康负有责任,因此重要的是,它们必须在地方一级实施干预措施,以解决影响获得医疗保健机会的差距。孤立的社区或与西班牙接壤的社区面临更严峻的挑战,需要当地政府给予更多关注。由于市政当局现在对健康负有责任,因此重要的是,它们必须在地方一级实施干预措施,以解决影响获得医疗保健机会的差距。孤立的社区或与西班牙接壤的社区面临更严峻的挑战,需要当地政府给予更多关注。由于市政当局现在对健康负有责任,因此重要的是,它们必须在地方一级实施干预措施,以解决影响获得医疗保健机会的差距。
更新日期:2020-09-29
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