title: A method to determine spatial access to specialized palliative care services using GIS.
abstract: BACKGROUND
  Providing palliative care is a growing priority for health service administrators worldwide as the populations of many nations continue to age rapidly. In many countries, palliative care services are presently inadequate and this problem will be exacerbated in the coming years. The provision of palliative care, moreover, has been piecemeal in many jurisdictions and there is little distinction made at present between levels of service provision. There is a pressing need to determine which populations do not enjoy access to specialized palliative care services in particular.
  
  
  METHODS
  Catchments around existing specialized palliative care services in the Canadian province of British Columbia were calculated based on real road travel time. Census block face population counts were linked to postal codes associated with road segments in order to determine the percentage of the total population more than one hour road travel time from specialized palliative care.
  
  
  RESULTS
  Whilst 81% of the province's population resides within one hour from at least one specialized palliative care service, spatial access varies greatly by regional health authority. Based on the definition of specialized palliative care adopted for the study, the Northern Health Authority has, for instance, just two such service locations, and well over half of its population do not have reasonable spatial access to such care.
  
  
  CONCLUSIONS
  Strategic location analysis methods must be developed and used to accurately locate future palliative services in order to provide spatial access to the greatest number of people, and to ensure that limited health resources are allocated wisely. Improved spatial access has the potential to reduce travel-times for patients, for palliative care workers making home visits, and for travelling practitioners. These methods are particularly useful for health service planners - and provide a means to rationalize their decision-making. Moreover, they are extendable to a number of health service allocation problems.
authors.affiliation: Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada. jca80@sfu.ca
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cinnamon
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
authors.forename: Valorie A
authors.initials: VA
authors.lastname: Crooks
mesh_terms: D002170:Canada; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D010166:Palliative Care / Q000706:statistics & numerical data*; D011365:Professional Practice Location; D012111:Residence Characteristics; D013997:Time Factors; D014195:Travel