Is neighborhood access to health care provision associated with individual-level utilization and satisfaction?
OBJECTIVE
To explore whether travel time access to the nearest general practitioner (GP) surgery (which is equivalent to U.S. primary care physician [PCP] office) and pharmacy predicts individual-level health service utilization and satisfaction.


METHODS
GP and pharmacy addresses were obtained from the New Zealand Ministry of Health in 2003 and merged with a geographic boundaries data set. Travel times derived from these data were appended to the 2002/03 New Zealand Health Survey (N=12,529).


METHODS
Multilevel logistic regression was used to model the relationship between travel time access and five health service outcomes: GP consultation, blood pressure test, cholesterol test, visit to pharmacy, and satisfaction with latest GP consultation.


METHODS
Travel times between each census meshblock centroid and the nearest GP and pharmacy were calculated using Geographical Information System.


RESULTS
When travel times were long, blood pressure tests were less likely in urban areas (odds ratio [OR] 0.75 [0.59-0.97]), GP consultations were less likely in rural centers (OR 0.42 [0.22-0.78]) and pharmacy visits were less likely in highly rural areas (OR 0.36 [0.13-0.99]). There was some evidence of lower utilization in rural areas.


CONCLUSIONS
Locational access to GP surgeries and pharmacies appears to sometimes be associated with health service use but not satisfaction.
Hiscock
Rosemary
R
GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand. rosemary.hiscock@canterbury.ac.nz
Pearce
Jamie
J
Blakely
Tony
T
Witten
Karen
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D040362:Geographic Information Systems; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D017060:Patient Satisfaction; D013222:State Medicine; D055815:Young Adult