Healthcare Accessibility

Healthcare accessibility refers to the extent to which people can easily obtain health services when needed. Measures of accessibility quantify the geographical separation of healthcare consumers and healthcare services, taking account of the distance, travel time, and cost. Geographic information systems have improved the accuracy and sophistication of geographical measures of accessibility, and facilitated inclusion of important “nonspatial” considerations that also influence peoples' level of accessibility to healthcare. Healthcare accessibility varies enormously between developed and developing countries. Generally there appears to be a direct “distance–decay” relationship between accessibility, health service utilization, and health outcomes. Accessibility has a direct impact on the burden of disease and is an important indicator of the performance of any national health system. Transport is a critical determinant of accessibility to health services, and distance and population distribution remain key elements especially in geographically large countries. Accessibility problems are usually worse in rural and remote areas, although intraurban accessibility differentials can be significant for marginalized populations. The recent global trend to close many local rural health services and centralize them in larger centers exacerbates problems of accessibility. Telemedicine and mobile services are increasingly important in overcoming the tyranny of distance.