Introduction

Public transport (PT) availability may be more important for people with disabilities (PWD), as typically they have greater healthcare needs and mobility barriers compared with people without disabilities. This paper investigates how PT availability is associated with healthcare use for people aged 18–60 years, with and without disabilities in Australia.

Method

We used unique Australian healthcare use administrative data linked to the 2016 Census, where individuals report whether they have a disability (severe or profound core activity limitation). These data were merged with detailed information on local area PT availability for Australia's 21 largest cities. We estimated regression models to examine the association between PT availability and different types of healthcare use, while controlling for individual characteristics and larger area attributes.

Results

PT availability was positively associated with visits to general practitioners (GP), with a higher magnitude observed for people with disabilities (PWD). While people without disabilities had on average 0.1 more GP visits per year when PT availability was high compared with low, PWD on average visited their GP 0.5 more times per year if they lived in areas with high as opposed to low PT availability. Nervous system prescriptions (which includes antidepressants) were 0.27 per year fewer for PWD living in areas with high compared with low PT availability. Conversely, nervous system scripts were 0.06 higher for people without disability with high compared with low PT availability.

Conclusion

We conclude that PT availability is likely to be a key factor of healthcare use. Increasing PT availability may help overcome some barriers to healthcare use for PWD. Our findings are also consistent with PT increasing access to preventive care, which may reduce the severity or better management of illnesses. PT can play an important role in improving health and decreasing health inequalities between those with and without disabilities.

中文翻译：

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18-60岁的澳大利亚成年人（有无残疾）的公共交通可用性和医疗保健用途

介绍

公共交通（PT）的可用性对于残疾人（PWD）可能更为重要，因为与非残疾人相比，公共交通通常具有更大的医疗保健需求和行动障碍。本文调查了18-60岁在澳大利亚有无残疾的人中，PT可用性与医疗保健的使用如何相关。

方法

我们使用了与2016年人口普查相关联的独特的澳大利亚医疗保健使用管理数据，其中个人报告他们是否有残疾（严重或严重的核心活动限制）。这些数据与有关澳大利亚21个最大城市的本地PT可用性的详细信息合并在一起。我们估计了回归模型，以检查PT可用性与不同类型的医疗保健用途之间的关联，同时控制个人特征和较大区域的属性。

结果

PT的可获得性与访问全科医生（GP）呈正相关，而残疾人（PWD）的访问量更高。当PT可用性高而不是低时，无残障人士每年平均有GP探访的次数多于0.1，而PPT如果居住在PT可用性低的地区，则平均每年探访GP的次数增加0.5。与PT利用率低的地区相比，生活在PWD较高地区的PWD的神经系统处方（包括抗抑郁药）每年减少0.27。相反，无残障人士的神经系统脚本比PT可用性低的人高0.06。

结论

我们得出的结论是，PT的可用性可能是医疗保健使用的关键因素。PT可用性的提高可能有助于克服PWD在医疗保健方面的一些障碍。我们的发现还与PT增加获得预防性护理的机会一致，这可以降低疾病的严重性或更好地管理疾病。PT在改善健康和减少残疾人与非残疾人之间的健康不平等方面可以发挥重要作用。