Population access to hospital emergency departments and the impacts of health reform in New Zealand

Abstract

In the current political climate of evidence-based research, GIS has emerged as a powerful research tool as it allows spatial and social health inequality to be explored efficiently. This article explores the impact health reforms had on geographical accessibility to hospital emergency department (ED) services in New Zealand from 1991 to 2001. Travel time was calculated using least-cost path analysis, which identified the shortest travel time from each census enumeration district through a road network to the nearest ED. This research found that the population further than 60 minutes from an ED has increased with some areas being affected more than others. Some of this increase is attributed to increases in population rather than the closing of hospitals. The findings will be discussed within the context of the health policy reform era and changes to health service provision.

What Is the “Right” Number of Hospital Beds for Palliative Population Health Needs?

“…In Canada, the average length of hospital stay is now 7.7 days, slightly more than the Organization for Economic Co-operation and Development (OECD) average of 7.2 [4]. Given the importance of hospitals, hospital accessibility for terminally-ill and dying people in need of hospital-based end-of-life or other hospital-based care services should be a matter of considerable worldwide interest [5]. Terminally-ill and dying people are among the most vulnerable of all people, and they often develop health concerns that tend to worsen over time [2,3].…”

“…To date, hospital accessibility has been commonly recognized as an issue for rural and remote populations, with travelling to larger communities often required for hospital access and with this situation raising concern over delayed access to necessary health care [5][6][7]. Reduced urban hospital accessibility has also been identified as a problem for new immigrants, disabled people, elderly persons, people living in poverty, minimally-educated people, homeless persons, and other defined disadvantaged sub-populations [8].…”

A Review and Framework for Categorizing Current Research and Development in Health Related Geographical Information Systems (GIS) Studies

“…Policy-makers and government officials have to make the decision, and this is where GIS can play an important role as a spatial decision support system, by informing the decision-makers of the pros and cons of different solutions [71][72][73][74]. An example of the use of GIS to reflect on the consequences of health care planning by Brabyn [75], who used GIS to calculate the percentage of the population who, as the result of a proposed health reform, must travel for more than one hour to reach an emergency department. Other examples would be the impact of closing a clinic in a region on service resource allocation and access.…”

Feasibility Study on an Evidence-Based Decision-Support System for Hospital Site Selection for an Aging Population

“…Drilling down into these data elements will improve the study's validity. The methodology used for quantitatively scoring each evaluation element (i.e., each sub-section of evaluation criteria) to create benchmarks for prioritized decision-making can be further enhanced by applying existing research about spatial-relation analysis, such as Moran's I and distance-based weighing methods [22,29,37]. In addition, to account for trade-offs among evaluation categories and their criteria, the methodology used for weighing each evaluation category and its criteria can be also refined using data-driven approaches and expanded focus group discussions.…”

“…Brabyn and Beere [22] developed a method for estimating the geographical accessibility of public hospitals based on the minimum travel time and distance to the closest hospital via a road network. Phillips et al [23] combined patient data with healthcare survey data to illustrate complex relationships that affect healthcare access by using GIS.…”