Accessibility to primary health care in low-density regions. A case study: NUTS III - Baixo Alentejo - Portugal

Freitas, Carlos; Costa, Nuno Marques da

doi:10.1590/1413-81232021266.1.40892020

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ARTICLE • Ciênc. Saúde Colet. 26 (suppl 1) • 2021 • https://doi.org/10.1590/1413-81232021266.1.40892020 copy

Accessibility to primary health care in low-density regions. A case study: NUTS III - Baixo Alentejo - Portugal

A acessibilidade aos cuidados de saúde primários em regiões de baixa densidade. Caso de estudo: NUTS III - Baixo Alentejo - Portugal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study diagnosed the situation regarding the physical accessibility of the resident population to primary health care, based on the characteristics of the population served, their spatial distribution in the territory, based on space-time analysis. Thus, bearing the different means of transport available and the specific features of a low-density territory, we considered several mobility profiles under analysis, and selected the Baixo Alentejo as the study area. In methodological terms, besides using the location of primary health facilities and their areas of influence, the use of the road network and its restrictions, we selected the use the new 1x1 km grid, recently implemented throughout the EU (European Union), instead of using the statistical units or administrative boundaries. Its advantages allow overcoming some of the issues of the usual base cartography. The final results can be divided into two groups: conclusions related to the methodologies used and conclusions related to the accessibility of primary health care equipment in the study area.

Key words:
Accessibility; Primary health care equipment; Low-population-density territories; 1 km² grid

Distance (m)	Grid cells		Area			Population %				Population % ∑
Distance (m)	nº	%	km²	%	% ∑	Total	< 15	[15-64]	> 64	Total	< 15	[15-64]	> 64
[0 - 1 000]	455	2.8	122.2	1.4	1.4	45.5	44.7	45.2	46.8	45.5	44.7	45.2	46.8
]1 000 - 2 000]	999	6.2	321.9	3.8	5.2	28.5	30.2	28.9	26.8	74.1	74.9	74.1	73.6
]2 000 - 5 000]	3218	20.1	1685.9	19.7	24.9	9.9	12.0	10.4	7.8	84.0	86.9	84.5	81.4
]5 000 - 10 000]	5329	33.3	2945.8	34.5	59.4	10.3	9.3	10.4	10.7	94.3	96.2	94.9	92.0
]10 000 - 25 000]	5042	31.5	2932.1	34.3	93.7	4.9	3.3	4.5	6.9	99.3	99.5	99.4	99.0
>25 000	956	6.0	534.9	6.3	100.0	0.7	0.5	0.6	1.0	100.0	100.0	100.0	100.0
Total	15999	100.0	8542.8	100.0		100.0	100.0	100.0	100.0

Distance (min)	Pedestrian profile 1				Pedestrian profile 2				Bicycle profile
Distance (min)	Total	< 15	[15-64]	> 64	Total	< 15	[15-64]	> 64	Total	< 15	[15-64]	> 64
[0 - 5]	8.8	8.5	8.7	9.3	5.3	5.1	5.3	5.6	59.4	59.0	59.2	60.3
]5 - 10]	22.5	22.0	22.3	23.2	15.1	14.6	14.9	15.7	20.4	23.0	21.0	17.4
]10 - 15]	20.1	20.2	20.1	20.1	18.4	18.2	18.3	18.6	3.1	3.8	3.2	2.6
]15-30]	25.6	27.6	26.1	23.3	31.2	32.4	31.3	30.2	9.5	8.9	9.6	9.8
>30	22.9	21.6	22.8	24.3	30.0	29.6	30.1	29.8	7.5	5.3	7.0	9.9
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0

Distance (min)	automotive profile
Distance (min)	Total	< 15	[15-64]	> 64
[0 - 5]	85.6	88.3	86.1	83.2
]5 - 10]	10.2	8.9	10.2	10.9
]10 - 15]	2.3	1.5	2.1	3.3
]15-30]	1.8	1.2	1.6	2.6
> 30	0.1	0.1	0.1	0.1
Total	100.0	100.0	100.0	100.0

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[1] Collaborations

Work conception and design: C Freitas and NM Costa. Theoretical framework: C Freitas and NM Costa. Selection of variables, collecting data, selecting variables, methodological implementation: C Freitas and NM Costa. Discussion of the results: C Freitas and NM Costa. Conclusions: C Freitas and NM Costa.