title: [Assessment of geographic accessibility in hierarchical health systems using the p-median model: an application in Santa Catarina State, Brazil].
abstract: The objective of this study is to compare the distribution of hospital units according to different degrees of specialization in Santa Catarina State, Brazil, based on an application of the p-median hierarchical model in three levels. The p-median model is used to determine the units' location, following by a comparison of the population's mean distance to reach the medical units in two scenarios, the current one and the simulation. A quantitative indicator of accessibility is proposed and used to assess accessibility according to the current and simulated distributions. The study aims to detect underserved regions and provides a tool to aid health managers' decision-making for possible interventions in the system in order to make it more homogeneous and accessible to the population.
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Silviana
authors.initials: S
authors.lastname: Cirino
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Louis Augusto
authors.initials: LA
authors.lastname: Gonçalves
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Mirian Buss
authors.initials: MB
authors.lastname: Gonçalves
authors.affiliation: Institut National des Sciences Appliquées de Rouen, Normandie, France.
authors.forename: Eduardo Souza de
authors.initials: ES
authors.lastname: Cursi
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, Brazil.
authors.forename: Antonio Sérgio
authors.initials: AS
authors.lastname: Coelho
mesh_terms: D001938:Brazil; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008962:Models, Theoretical; D009313:National Health Programs; D012111:Residence Characteristics; D012959:Socioeconomic Factors