Estimation of a geographic accessibility index of different health centers in Mexico

Abstract

Background: The accessibility to health centers is a limitation to the use of preventive and curative health centers. Aim: To assess geographic accessibility using a parameter that integrates information about the use of preventive services and travelling time from home to the health center. Material and methods: We analyzed target geographical areas of 10 community centers located at the Northeast of Mexico. A survey was conducted to collect information about the utilization of preventive services for detection of diabetes and hypertension within last year and in women, detection of cervical and breast cancer. The time required to travel between the health center and the farthest location point at every neighborhood of each geographic areas, using public or private transportation, was calculated. Health service use and transporation time were condensed in a single parameter, called geographic accessibility index. Data was normalized using z scores. Results: Three geographical areas denominated 7, 8 and 10 had the lowest detection rates of chronic diseases, with values ranging from 45\% to 48\%. By car, area number 3 had the longest travelling line, corresponding to 14 minutes. The longest travelling times by public transportation were detected in areas 1 and 3, corresponding to 27 and 29 minutes, respectively. The geographic accessibility index showed that the least favorable z scores travelling by car corresponded to areas 6 and 10 and, when travelling on public transportation, to areas 8 and 10. Conclusions: The geographic accessibility index identified areas that required improvemetns in accessibility (Rev Med Chile 2008; 136: 1574-81).