title: Variables associated with utilization of a centralized medical post in the Andean community of Pampas Grande, Peru.
abstract: BACKGROUND
  Integral to the location of health resources is the distance decay of utilization observed in a population. In rural Peru, a nongovernmental organization planning to increase the availability of health services needed this information.
  
  
  OBJECTIVE
  To determine variables associated with utilization of a central medical clinic and determine whether, because of the mountainous topography, travel time (TT) would be a better predictor of utilization than distance.
  
  
  METHODS
  A door-to-door survey of all available households (81% of total), using a Spanish translation of questions excerpted from the Behavioral Risk Factor Surveillance System Survey, was conducted in the summer of 2008 to determine variables associated with self-reported history of clinic utilization.
  
  
  RESULTS
  Utilization was inversely related to TT and distance. Of those living within 5 minutes of the clinic, 61% had been to the clinic whereas only 25% of those living 30 or more minutes away had sought care. Female gender and fever predicted increased odds of clinic utilization. Having a disability reduced one's odds (OR 0.55) of visiting the clinic, after adjusting for gender, TT, and fever. The inverse correlation of utilization with travel distance and TT was not significantly different, thus failing to demonstrate that TT is a better predictor of utilization than distance.
  
  
  CONCLUSIONS
  In health service planning, care for common conditions should be available within 5 minutes' TT or a few kilometers' distance from each person's home in order to improve health care access and reduce health care disparities worsened by disability.
authors: Department of Family Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. merry.stephen@mayo.edu
authors: Stephen P
authors: SP
authors: Merry
authors: James E
authors: JE
authors: Rohrer
authors: Thomas D
authors: TD
authors: Thacher
authors: Matthew R
authors: MR
authors: Summers
authors: Jonathan D
authors: JD
authors: Alpern
authors: Robert W
authors: RW
authors: Contino
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013997:Time Factors