Distance, rurality and the need for care: access to health services in South West England

摘要: This paper explores the geographical accessibility of health services in urban and rural areas South West England, comparing two measures access characterising most remote from hospitals. Straight-line distance drive-time to nearest general practice (GP) acute hospital (DGH) were calculated for postcodes aggregated 1991 Census wards. The correlation between was used identify wards where straight-line not an accurate predictor drive-time. Wards over 25 km a DGH classified as 'remote', characterised terms rurality, deprivation, age structure status population. highly correlated (r2>0.93). greatest differences found coastal far West. Median GPs 1 (IQR = 0.6–2 km) DGHs, 12 5–19 km). Deprivation rates premature limiting long term illness raised distant hospitals, but there no evidence higher mortality rates. Half classed by Office National Statistics. Almost quarter households furthest hospitals had car, proportion with or more cars fell areas. Drive-time is measure peripheral Geographical services, especially GPs, good, remoteness affects both areas: studies concentrating purely on may underestimate barriers accessing care. A sizeable minority still car 1991, few than one particularly very close Better access, which integrate public private transport availability travel time, are required if reflection experience those without their own be obtained.