Measuring Distance to Nearest Medical Personnel
Distance may be measured in terms of cost or the time it takes
a person to travel to a health care facility or to the location
of health care personnel. Or, a measure of the psychological barrier
of distance may be used. But none of these measures are available
at the present time in datasets that would provide consistent or
standard information for this country-wide analysis. Instead, the
more commonly used "straight line" or "as the crow
flies" distances have been computed for a number of health
care professionals and facilities. This approach is not new. In
Canada, some of the most frequently cited examples of this procedure
include the work of Angus and Brothers (1976), Ng et al. (1993,
1997 and 1999), and Pitblado and Pong (1999).
Using the procedure outlined by Ng et al. (1993 and 1997), several
distance measurements were computed for the Rural Health issue reported
here:
From:
The geographical locations of the Canadian population at each of
49 361 enumeration areas expressed in terms of latitude and longitude.
(Data Source: Statistics Canada.)
To:
The nearest geographical location expressed in terms of enumeration
area latitude and longitude of each of the physician types listed
below. (Data Source: 1998 Southam Medical Database of the Canadian
Institute for Health Information.)
a) Family physician
b) Physician specialist (i.e. not differentiated by speciality)
c) Physician specialists differentiated by the following specialties:
- internal medicine
- pediatrics
- psychiatry
- anesthesia
- diagnostic radiology
- general surgery
- obstetrics and gynecology
- orthopedic surgery
In this analysis, a population-to-physician distance was not measured
if the physician type or category was not in the same province/territory
as the population site or location. Each of these distance measures
was then averaged for each of the physician types for each of the
288 census divisions in Canada.
Graphical summaries of the average distances to the physician categories
below (Figures 1 to 8) are provided using the urban/rural categories
defined by the Organization for Economic Co-Operation and Development
(OECD) system. These summaries are provided for information purposes,
without commentary as they are reasonably self explanatory.
[D] Click for larger version, 3 KB Figure 1. Average Distance to the Nearest Specialist in Internal Medicine, 1998
[D] Click for larger version, 3 KB Figure 2. Average Distance to the Nearest Specialist in Pediatrics, 1998
[D] Click for larger version, 3 KB Figure 3. Average Distance to the Nearest Specialist in Psychiatry, 1998
[D] Click for larger version, 3 KB Figure 4. Average Distance to the Nearest Specialist in Anesthesia, 1998
[D] Click for larger version, 3 KB Figure 5. Average Distance to the Nearest Specialist in Diagnostic Radiology, 1998
[D] Click for larger version, 3 KB Figure 6. Average Distance to the Nearest Specialist in General Surgery, 1998
[D] Click for larger version, 3 KB Figure 7. Average Distance to the Nearest Specialist in Obstetrics & Gynecology, 1998
[D] Click for larger version, 3 KB Figure 8. Average Distance to the Nearest Specialist in Orthopedic Surgery, 1998
Similar graphical summaries and census division maps are provided
for the average distances to the nearest family physician and the
nearest physician specialist.
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