Spatial Healthcare Accessibility: A District-Level Analysis of Travel for Outpatient Diabetology in Czechia

Abstract

Assessments of regional differences in the accessibility and capacity of health services often rely on indicators based on data from the permanent residents of a given region. However, a patient does not always use health services in their place of residence. The objective of this article is to evaluate the influence of spatial healthcare accessibility on regional differences in the provision and take-up of health services, using outpatient diabetology in Czechia as a case study. The analysis is grounded in monitoring the differences in the patient’s place of residence and the location of the healthcare provided. Anonymized individual data of the largest Czech health insurance company for 2019 are used (366,537 patients, 2,481,129 medical procedures). The data are aggregated at the district level (LAU 1). It has been identified that regions where patients travel outside their area of residence to access more than half of their healthcare needs are mostly in local/regional centres. Moreover, these patients increase the number of medical services provided in local/regional centres, often by more than 20%, which has been reflected in greater healthcare capacity in these centres. To assess regional differences, it is important to take the spatial healthcare accessibility into account and also consider why patients travel for healthcare. Reasons could be the insufficient local capacity, varied quality of health services or individual factors. In such cases, healthcare actors (health insurance companies, local government etc.) should respond to the situation and take appropriate action to reduce these dissimilarities.

A holistic model of health inequalities for health policy and state administration: a case study in the regions of the Czech Republic

“…They reflect the uneven distribution of health risks within the context of geographical characteristics. The combined influence of economic, social [ 26 , 27 , 29 ], and environmental factors [ 44 , 50 , 51 ], along with the availability of local health [ 60 , 67 ] and social care [ 7 , 61 ], contribute to regional health disparities. At the spatial scale, both the inner and outer peripheries of LAU1 in the Czech Republic exhibit poorer performance, although it is necessary to differentiate between urban and rural peripheries.…”

“…Category A.7 Sources of health and social care: The availability and accessibility of health care services are generally improving, although studies indicate lower health care utilization in regions with lower density and availability of medical care [ 58 – 60 ]. There is an increasing interest in utilizing social care data, including sources of social care, as the demand for both quantity and quality of care rises due to population aging.…”