IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v120y2016i2p205-212.html
   My bibliography  Save this article

Developing a composite index of spatial accessibility across different health care sectors: A German example

Author

Listed:
  • Siegel, Martin
  • Koller, Daniela
  • Vogt, Verena
  • Sundmacher, Leonie

Abstract

The evolving lack of ambulatory care providers especially in rural areas increasingly challenges the strict separation between ambulatory and inpatient care in Germany. Some consider allowing hospitals to treat ambulatory patients to tackle potential shortages of ambulatory care in underserved areas. In this paper, we develop an integrated index of spatial accessibility covering multiple dimensions of health care. This index may contribute to the empirical evidence concerning potential risks and benefits of integrating the currently separated health care sectors. Accessibility is measured separately for each type of care based on official data at the district level. Applying an Improved Gravity Model allows us to factor in potential cross-border utilization. We combine the accessibilities for each type of care into a univariate index by adapting the concept of regional multiple deprivation measurement to allow for a limited substitutability between health care sectors. The results suggest that better health care accessibility in urban areas persists when taking a holistic view. We believe that this new index may provide an empirical basis for an inter-sectoral capacity planning.

Suggested Citation

  • Siegel, Martin & Koller, Daniela & Vogt, Verena & Sundmacher, Leonie, 2016. "Developing a composite index of spatial accessibility across different health care sectors: A German example," Health Policy, Elsevier, vol. 120(2), pages 205-212.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:2:p:205-212
    DOI: 10.1016/j.healthpol.2016.01.001
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851016000026
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2016.01.001?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Michael Noble & Gemma Wright & George Smith & Chris Dibben, 2006. "Measuring Multiple Deprivation at the Small-Area Level," Environment and Planning A, , vol. 38(1), pages 169-185, January.
    2. Scott, Anthony & Witt, Julia & Humphreys, John & Joyce, Catherine & Kalb, Guyonne & Jeon, Sung-Hee & McGrail, Matthew, 2013. "Getting doctors into the bush: General Practitioners' preferences for rural location," Social Science & Medicine, Elsevier, vol. 96(C), pages 33-44.
    3. Joseph, Alun E. & Bantock, Peter R., 1982. "Measuring potential physical accessibility to general practitioners in rural areas: A method and case study," Social Science & Medicine, Elsevier, vol. 16(1), pages 85-90, January.
    4. Hancock, Christine & Steinbach, Alan & Nesbitt, Thomas S. & Adler, Shelley R. & Auerswald, Colette L., 2009. "Why doctors choose small towns: A developmental model of rural physician recruitment and retention," Social Science & Medicine, Elsevier, vol. 69(9), pages 1368-1376, November.
    5. Cockings, Samantha & Martin, David, 2005. "Zone design for environment and health studies using pre-aggregated data," Social Science & Medicine, Elsevier, vol. 60(12), pages 2729-2742, June.
    6. Weinhold, Ines & Gurtner, Sebastian, 2014. "Understanding shortages of sufficient health care in rural areas," Health Policy, Elsevier, vol. 118(2), pages 201-214.
    7. Sundmacher, Leonie & Busse, Reinhard, 2011. "The impact of physician supply on avoidable cancer deaths in Germany. A spatial analysis," Health Policy, Elsevier, vol. 103(1), pages 53-62.
    8. Thomas Kopetsch & Hendrik Schmitz, 2014. "Regional Variation In The Utilisation Of Ambulatory Services In Germany," Health Economics, John Wiley & Sons, Ltd., vol. 23(12), pages 1481-1492, December.
    9. Till Bärnighausen & David E. Bloom, 2008. "Financial incentives for return of service in underserved areas: a systematic review," PGDA Working Papers 3608, Program on the Global Demography of Aging.
    10. Vogt, Verena & Siegel, Martin & Sundmacher, Leonie, 2014. "Examining regional variation in the use of cancer screening in Germany," Social Science & Medicine, Elsevier, vol. 110(C), pages 74-80.
    11. Flowerdew, Robin & Manley, David J. & Sabel, Clive E., 2008. "Neighbourhood effects on health: Does it matter where you draw the boundaries?," Social Science & Medicine, Elsevier, vol. 66(6), pages 1241-1255, March.
    12. Martin Siegel & Andreas Mielck & Werner Maier, 2015. "Individual Income, Area Deprivation, and Health: Do Income‐Related Health Inequalities Vary by Small Area Deprivation?," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1523-1530, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    2. Freiria, Susana & Tavares, Alexandre O. & Julião, Rui Pedro, 2019. "The benefits of a link-based assessment of health services accessibility: Unveiling gaps in Central Region of Portugal," Land Use Policy, Elsevier, vol. 87(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Feder-Bubis, Paula & Bin-Nun, Gabi & Zarhin, Dana & Sherf, Michael & Heiman-Neuman, Nitza, 2023. "Residents' choice of a placement in periphery hospitals in Israel: The significance of personal/family and professional considerations," Health Policy, Elsevier, vol. 132(C).
    2. Eibich, Peter & Ziebarth, Nicolas, 2014. "Examining the Structure of Spatial Health Effects in Germany Using Hierarchical Bayes Models," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 49, pages 305-320.
    3. Hamidreza Rabiei‐Dastjerdi & Stephen A. Matthews, 2021. "Who gets what, where, and how much? Composite index of spatial inequality for small areas in Tehran," Regional Science Policy & Practice, Wiley Blackwell, vol. 13(1), pages 191-205, February.
    4. Danny Wende, 2019. "Spatial risk adjustment between health insurances: using GWR in risk adjustment models to conserve incentives for service optimisation and reduce MAUP," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1079-1091, September.
    5. Samantha Cockings & Andrew Harfoot & David Martin & Duncan Hornby, 2013. "Getting the Foundations Right: Spatial Building Blocks for Official Population Statistics," Environment and Planning A, , vol. 45(6), pages 1403-1420, June.
    6. Holte, Jon Helgheim & Kjaer, Trine & Abelsen, Birgit & Olsen, Jan Abel, 2015. "The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 1-9.
    7. Chunzhu Wei & Pablo Cabrera-Barona & Thomas Blaschke, 2016. "Local Geographic Variation of Public Services Inequality: Does the Neighborhood Scale Matter?," IJERPH, MDPI, vol. 13(10), pages 1-20, October.
    8. Samantha Cockings & Andrew Harfoot & David Martin & Duncan Hornby, 2011. "Maintaining Existing Zoning Systems Using Automated Zone-Design Techniques: Methods for Creating the 2011 Census Output Geographies for England and Wales," Environment and Planning A, , vol. 43(10), pages 2399-2418, October.
    9. McGrail, Matthew R. & Humphreys, John S. & Joyce, Catherine M. & Scott, Anthony, 2012. "International medical graduates mandated to practise in rural Australia are highly unsatisfied: Results from a national survey of doctors," Health Policy, Elsevier, vol. 108(2), pages 133-139.
    10. Scott, Anthony & Witt, Julia & Humphreys, John & Joyce, Catherine & Kalb, Guyonne & Jeon, Sung-Hee & McGrail, Matthew, 2013. "Getting doctors into the bush: General Practitioners' preferences for rural location," Social Science & Medicine, Elsevier, vol. 96(C), pages 33-44.
    11. Rainham, Daniel & McDowell, Ian & Krewski, Daniel & Sawada, Mike, 2010. "Conceptualizing the healthscape: Contributions of time geography, location technologies and spatial ecology to place and health research," Social Science & Medicine, Elsevier, vol. 70(5), pages 668-676, March.
    12. Chunzhu Wei & Mark Padgham & Pablo Cabrera Barona & Thomas Blaschke, 2017. "Scale-Free Relationships between Social and Landscape Factors in Urban Systems," Sustainability, MDPI, vol. 9(1), pages 1-19, January.
    13. Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    14. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    15. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2021. "A Demand-Oriented Approach to Health Care Capacity Planning," IZA Discussion Papers 14860, Institute of Labor Economics (IZA).
    16. Cindy M. Padilla & Wahida Kihal-Talantikit & Verónica M. Vieira & Séverine Deguen, 2016. "City-Specific Spatiotemporal Infant and Neonatal Mortality Clusters: Links with Socioeconomic and Air Pollution Spatial Patterns in France," IJERPH, MDPI, vol. 13(6), pages 1-21, June.
    17. Kuhn, Michael & Ochsen, Carsten, 2019. "Population change and the regional distribution of physicians," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    18. Sabel, C.E. & Kihal, W. & Bard, D. & Weber, C., 2013. "Creation of synthetic homogeneous neighbourhoods using zone design algorithms to explore relationships between asthma and deprivation in Strasbourg, France," Social Science & Medicine, Elsevier, vol. 91(C), pages 110-121.
    19. Li, Jinhu & Scott, Anthony & McGrail, Matthew & Humphreys, John & Witt, Julia, 2014. "Retaining rural doctors: Doctors' preferences for rural medical workforce incentives," Social Science & Medicine, Elsevier, vol. 121(C), pages 56-64.
    20. Jin, Tanhua & Cheng, Long & Wang, Kailai & Cao, Jun & Huang, Haosheng & Witlox, Frank, 2022. "Examining equity in accessibility to multi-tier healthcare services across different income households using estimated travel time," Transport Policy, Elsevier, vol. 121(C), pages 1-13.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:120:y:2016:i:2:p:205-212. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.