Oral Presentation The Institute of Australian Geographers Conference 2023

Measuring spatial access to health services in Australia: a review of current approaches (18365)

Sarah M Wood 1 , Laura Alston 1 2 , Hannah Beks 1 , Kevin Mc Namara 1 3 , Neil T Coffee 1 4 , Robyn A Clark 5 6 , Anna Wong Shee 1 3 , Vincent L Versace 1 3
  1. Deakin Rural Health, Deakin University, Warrnambool, Victoria, Australia
  2. Research Unit, Colac Area Health, Colac, Victoria, Australia
  3. Grampians Health, Ballarat, Victoria, Australia
  4. University of Canberra, Canberra, Victoria, Australia
  5. Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
  6. Southern Adelaide Health Care Services, Adelaide, South Australia, Australia

Background: Australia's inequitable spatial distribution of health services is well documented. Understanding how access to health services is measured is fundamental to addressing health inequity in Australia. Measuring access contributes to a broader understanding of the performance of health systems, particularly in disadvantaged communities. A lack of analysis of the use of existing measures inhibits the ability to assess the appropriateness of spatial access measures in line with national policy. This study synthesised the evidence on the spatial measures and geographic classifications used to measure health service access in Australia over the past 20 years.

Methods: A systematic review of the literature was undertaken, with search terms derived from three major topics, including: [1] Australian population; [2] spatial analysis of health service accessibility; and [3] objective physical access measures.

Results: Eighty-two articles met the eligibility criteria. Most articles analysed access to primary health services (n=50; 61%), followed by specialist care (n=17; 21%), hospital services (n=12; 15%), and health promotion and prevention (n=3; 4%). The geographic scope of the articles mainly focused on national (n=33; 40%), state (n=27; 33%), and metropolitan area (n=18; 22%) levels, with regional/rural/remote areas the least represented (n=4; 5%). Most articles used distance-based physical access measures, including travel time (n=30; 37%), travel distance along a road network (n=21; 26%), and Euclidean distance (n=24; 29%).

Conclusion: This review identified substantial heterogeneity in the spatial measures and geographic classifications used to examine health service access, making direct comparisons difficult. Objective and transparent access measures that are fit for purpose are imperative to address persistent health inequities and inform equitable resource distribution and evidence-based policymaking. Future research should aim to analyse access at the finest resolution and, where possible and appropriate, aim to use standardised approaches to classifying rural and remote populations relevant to the purpose of the study.