title: Defining rational hospital catchments for non-urban areas based on travel-time.
abstract: BACKGROUND
  Cost containment typically involves rationalizing healthcare service delivery through centralization of services to achieve economies of scale. Hospitals are frequently the chosen site of cost containment and rationalization especially in rural areas. Socio-demographic and geographic characteristics make hospital service allocation more difficult in rural and remote regions. This research presents a methodology to model rational catchments or service areas around rural hospitals--based on travel time.
  
  
  RESULTS
  This research employs a vector-based GIS network analysis to model catchments that better represent access to hospital-based healthcare services in British Columbia's rural and remote areas. The tool permits modelling of alternate scenarios in which access to different baskets of services (e.g. rural maternity care or ICU) are assessed. In addition, estimates of the percentage of population that is served--or not served--within specified travel times are calculated.
  
  
  CONCLUSIONS
  The modelling tool described is useful for defining true geographical catchments around rural hospitals as well as modelling the percentage of the population served within certain time guidelines (e.g. one hour) for specific health services. It is potentially valuable to policy makers and health services allocation specialists.
authors.affiliation: Department of Geography, Simon Fraser University, Burnaby, Canada. nadine@sfu.ca
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Fiedler
authors.forename: Stefan C W
authors.initials: SC
authors.lastname: Grzybowski
authors.forename: Darrin
authors.initials: D
authors.lastname: Grund
mesh_terms: D001955:British Columbia; D002391:Catchment Area, Health / Q000191:economics*; D040362:Geographic Information Systems / Q000458:organization & administration*; D006297:Health Services Accessibility; D006780:Hospitals, Rural; D006801:Humans; D019035:Rural Health Services / Q000191:economics / Q000706:statistics & numerical data*; D013997:Time Factors; D014195:Travel / Q000706:statistics & numerical data