Measuring Accessibility to Primary Health Care Across the Urban-rural Continuum in the Province of Alberta

The proper estimation of accessibility is necessary to understand the issue of the urban-rural divide in access health care. The main concern with the previously developed accessibility measures is that the urban-rural continuum is treated as a dichotomous variable, while many degrees of rurality exist. While many studies attempted to include a distance decay function to address local travel patterns, it is usually arbitrary and may not exactly reflect the reality. This project is an attempt to improve the current methodology and make it more suitable for provincial settings that include various degrees of rurality. The past records of health care utilization are analyzed and distance decay coefficients are extracted for each type of urban and rural area. These coefficients are used to enhance a commonly used two-step floating catchment area (2SFCA) method to estimate accessibility scores. In addition, health needs and mobility measures are added to the model. The result of this enhanced methodology is compared to other methods where distance decay is used. The proposed method consistently shows better and more accurate results. The alternative methods often underestimate accessibility, especially in remote areas. The distance decay function derived from actual utilization data also allows use of this approach for large areas such as a Canadian province.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Discipline thesis:degree_discipline

Geography

Grantor dc:publisher.institution

Graduate Studies

Year dc:date.issued

2016

Author dc:creator

• Barrett, Olesya

Advisor dc:contributor.advisor

• Bertazzon, Stefania

Committee members dc:contributor.committeemember

• Miller, Byron
• Hemmelgarn, Brenda
• Patel, Alka
• Yiannakoulias, Nikolaos

• Geography
• Public Health
• Statistics

Statement dc:rights

• University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.

Language dc:language.iso

eng

DOI

http://dx.doi.org/10.11575/PRISM/26852

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:11023/2929