IDEAS home Printed from https://ideas.repec.org/p/wiw/wiwrsa/ersa14p1390.html
   My bibliography  Save this paper

Determinants of Access to Healthcare: A Survey in Istanbul

Author

Listed:
  • Muhammed Ziya Paköz
  • Mehmet Ali Yüzer

Abstract

Access to healthcare is formed according to the characteristics of the supply and demand. While siting hospitals, ?equity' in access to healthcare should be taken as a basis for all segments of society, and necessary measures should be taken to ensure that vulnerable groups benefit from health services adequately. This necessitates evaluating spatial and non-spatial dimensions of access to healthcare together. Spatial dimension emphasizes importance of the distance whereas non-spatial dimension includes factors such as level of income, educational attainment level, culture, ethnicity, age and sex. In this paper, results of the survey conducted on 756 households in Istanbul were put to evaluation within the framework of the dimensions of the access to healthcare; spatial patterns of the access to inpatient services in Istanbul were examined over the survey results. Dimensions of the access to healthcare put forward the level of access as well. Results of the survey show that different dimensions of the access to healthcare are effective with various degrees in hospital choices. However, as the level of income changes, so does the hospital preferences. Middle and low income groups have more limited budget for healthcare services and ownership of personal car is less frequent, so demand elasticity is lower compared to the high and high-middle income groups. Therefore, ?accessibility' and ?affordability' dimensions of the access come to the fore for middle and low income groups while ?acceptability' is cared more by the high and high-middle income groups. The paper also deals with the relationship between supply characteristics and travel time / travel distance accepted and realized for going to hospital in Istanbul. According to the international practices and literature, the maximum travel time for access to hospital is accepted generally as ?30 minutes', which turns out to be parallel with the survey results. However, the realized travel distance differentiates based on the type (public, private) and nature (regional-local) of the hospital. Distance covered for regional hospitals (training and research hospitals and university hospitals) and travel rate outside the district are higher than the distance covered for local hospitals. Similarly, distance covered for private hospitals is more than the distance made for public hospitals. The paper not only evaluates the spatial and non-spatial factors together, but also considers health supply in various aspects, reveals user behaviors which change depending on the type of the supply and the characteristics and the pattern of the city, and defines distance thresholds and border-crossing according to these features.

Suggested Citation

  • Muhammed Ziya Paköz & Mehmet Ali Yüzer, 2014. "Determinants of Access to Healthcare: A Survey in Istanbul," ERSA conference papers ersa14p1390, European Regional Science Association.
    • Handle: RePEc:wiw:wiwrsa:ersa14p1390
    as

    Download full text from publisher

    File URL: https://www-sre.wu.ac.at/ersa/ersaconfs/ersa14/e140826aFinal01390.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Liu, Yuanli & Hsiao, William C. & Eggleston, Karen, 1999. "Equity in health and health care: the Chinese experience," Social Science & Medicine, Elsevier, vol. 49(10), pages 1349-1356, November.
    2. Govind, Rahul & Chatterjee, Rabikar & Mittal, Vikas, 2008. "Timely access to health care: Customer-focused resource allocation in a hospital network," International Journal of Research in Marketing, Elsevier, vol. 25(4), pages 294-300.
    3. Goodman, D.C. & Fisher, E. & Slukel, T.A. & Chang, C.-H., 1997. "The distance to community medical care and the likelihood of hospitalization: Is closer always better?," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1144-1150.
    4. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    5. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
    6. Tuğba şentürk & Fatih Terzi & Vedia Dokmeci, 2011. "Privatization of Health-care Facilities in Istanbul," European Planning Studies, Taylor & Francis Journals, vol. 19(6), pages 1117-1130, June.
    Full references (including those not matched with items on IDEAS)

    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. Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, MIT Press, vol. 5(3), pages 334-359, Summer.
    2. Marissa B Kosnik & David M Reif & Danelle T Lobdell & Thomas Astell-Burt & Xiaoqi Feng & John D Hader & Jane A Hoppin, 2019. "Associations between access to healthcare, environmental quality, and end-stage renal disease survival time: Proportional-hazards models of over 1,000,000 people over 14 years," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-17, March.
    3. Mark Burkey, 2012. "Decomposing geographic accessibility into component parts: methods and an application to hospitals," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 48(3), pages 783-800, June.
    4. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    5. Burkey, M.L. & Bhadury, J. & Eiselt, H.A., 2012. "A location-based comparison of health care services in four U.S. states with efficiency and equity," Socio-Economic Planning Sciences, Elsevier, vol. 46(2), pages 157-163.
    6. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    7. Chen, Zhuo & Eastwood, David B. & Yen, Steven T., 2005. "Childhood Malnutrition In China: Change Of Inequality In A Decade," 2005 Annual meeting, July 24-27, Providence, RI 19205, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    8. Schmid, Andreas, 2007. "Incentive Compatibility and Efficiency in the contractual Insurer-Provider Relationship: Economic Theory and practical Implications: The Case of North Carolina," MPRA Paper 23311, University Library of Munich, Germany, revised 2008.
    9. Kyu-Tae Han & Woorim Kim & Seungju Kim, 2021. "Does Delaying Time in Cancer Treatment Affect Mortality? A Retrospective Cohort Study of Korean Lung and Gastric Cancer Patients," IJERPH, MDPI, vol. 18(7), pages 1-10, March.
    10. Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    11. Paul Anand & Jere R. Behrman & Hai-Anh H. Dang & Sam Jones, 2018. "Inequality of opportunity in education: Accounting for the contributions of Sibs, schools and sorting across East Africa," Working Papers 480, ECINEQ, Society for the Study of Economic Inequality.
    12. Dolan, Paul & Edlin, Richard & Tsuchiya, Aki & Wailoo, Allan, 2007. "It ain't what you do, it's the way that you do it: Characteristics of procedural justice and their importance in social decision-making," Journal of Economic Behavior & Organization, Elsevier, vol. 64(1), pages 157-170, September.
    13. Fischer, Stefanie & Royer, Heather & White, Corey, 2017. "The Impacts of Reduced Access to Abortion and Family Planning Services: Evidence from Texas," IZA Discussion Papers 10920, Institute of Labor Economics (IZA).
    14. Majo, Maria Cristina & van Soest, Arthur, 2012. "Income and health care utilization among the 50+ in Europe and the US," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 28(4), pages 3-22.
    15. Fredriksson, Anders, 2017. "Location-allocation of public services – Citizen access, transparency and measurement. A method and evidence from Brazil and Sweden," Socio-Economic Planning Sciences, Elsevier, vol. 59(C), pages 1-12.
    16. repec:dau:papers:123456789/13753 is not listed on IDEAS
    17. Paul Anand & Laurence S. J. Roope & Anthony J. Culyer & Ron Smith, 2020. "Disability and multidimensional quality of life: A capability approach to health status assessment," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 748-765, July.
    18. Yongqing Dong & Quheng Deng & Shaoping Li, 2022. "The Health Inequality of Children in China: A Regression-Based Decomposition Analysis," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 15(1), pages 137-159, February.
    19. Win Lin Chou & Zijun Wang, 2009. "Regional inequality in China's health care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 137-146, July.
    20. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 343-368, December.
    21. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2020. "Planning health care capacities with a gravity equation," Ruhr Economic Papers 888, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

    More about this item

    Keywords

    Access to healthcare; affordability; spatial accessibility; distance; Istanbul (and);
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:wiw:wiwrsa:ersa14p1390. 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: Gunther Maier (email available below). General contact details of provider: http://www.ersa.org .

    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.