Skip to main content
NCBI home page
Health Services Research logoLink to Health Services Research
. 1995 Feb;29(6):629–651.

The geographical accessibility of hospitals to the aged: a geographic information systems analysis within Illinois.

D Love 1, P Lindquist 1
PMCID: PMC1070036  PMID: 7860317

Abstract

OBJECTIVE. This article uses geographic information systems and their related tools to empirically measure and display the geographic accessibility of the aged population to hospital facilities within Illinois. DATA SOURCES AND STUDY SETTING. Geographic accessibility of Illinois' aged population is measured from each of the state's 10,796 census block groups to the state's 214 hospital facilities. Block group demographic compositions and centroids are obtained from 1990 census files. Hospital coordinates are obtained by the authors. STUDY DESIGN. Of five alternative measures of accessibility considered, empirical estimates are obtained for two: choice set and minimum distance. Access to both general hospitals and the subset having specialized geriatric facilities is measured with special attention to differences in accessibility between the aged within metropolitan statistical areas (MSAs) and those outside MSAs. Cumulative accessibility distributions and their summary statistics provide a basis of comparison among subgroups. DATA COLLECTION AND EXTRACTION. Geographic information systems (GIS) and their related tools are used as a means of efficiently capturing, organizing, storing, and retrieving the required data. Hospitals and census block groups are geocoded to specific locations in the database, and aspatial attributes are assigned to the hospitals and block groups. The GIS database is queried to produce shaded isarithm and point distribution maps that show the location of hospitals relative to surrounding aged populations. CONCLUSION. The vast majority of Illinois' aged population is within close proximity to hospital facilities. Eighty percent (1,147,504 persons) of the aged in Illinois are within 4.8 miles (7.7 km) of a hospital and 11.6 miles (18.7 km) of two hospitals. However, geographic accessibility differences between the aged living in MSAs and those living outside MSAs to hospitals offering geriatric services are substantial; but there is no evidence that the aged's geographical accessibility to hospitals is less favorable than that of the general population. Detailed accessibility measures permitted by geographic information system technology call into question the continued use of crude empirical accessibility measures.

Full text

PDF
629

Images in this article

640Figure 2
on p.640

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aday L. A., Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974 Fall;9(3):208–220. [PMC free article] [PubMed] [Google Scholar]
  2. Andersen R. M., McCutcheon A., Aday L. A., Chiu G. Y., Bell R. Exploring dimensions of access to medical care. Health Serv Res. 1983 Spring;18(1):49–74. [PMC free article] [PubMed] [Google Scholar]
  3. Bronstein J. M., Morrisey M. A. Bypassing rural hospitals for obstetrics care. J Health Polit Policy Law. 1991 Spring;16(1):87–118. doi: 10.1215/03616878-16-1-87. [DOI] [PubMed] [Google Scholar]
  4. Christianson J. B., Moscovice I. S., Johnson J., Kralewski J., Grogan C. Evaluating rural hospital consortia. Health Aff (Millwood) 1990 Spring;9(1):135–147. doi: 10.1377/hlthaff.9.1.135. [DOI] [PubMed] [Google Scholar]
  5. Davis K. Inequality and access to health care. Milbank Q. 1991;69(2):253–273. [PubMed] [Google Scholar]
  6. Garnick D. W., Lichtenberg E., Phibbs C. S., Luft H. S., Peltzman D. J., McPhee S. J. The sensitivity of conditional choice models for hospital care to estimation technique. J Health Econ. 1989;8(4):377–397. doi: 10.1016/0167-6296(90)90022-u. [DOI] [PubMed] [Google Scholar]
  7. Garnick D. W., Luft H. S., Robinson J. C., Tetreault J. Appropriate measures of hospital market areas. Health Serv Res. 1987 Apr;22(1):69–89. [PMC free article] [PubMed] [Google Scholar]
  8. Gesler W. M., Meade M. S. Locational and population factors in health care-seeking behavior in Savannah, Georgia. Health Serv Res. 1988 Aug;23(3):443–462. [PMC free article] [PubMed] [Google Scholar]
  9. Goody B. Defining rural hospital markets. Health Serv Res. 1993 Jun;28(2):183–200. [PMC free article] [PubMed] [Google Scholar]
  10. Jecker N. S., Berg A. O. Allocating medical resources in rural America: alternative perceptions of justice. Soc Sci Med. 1992 Mar;34(5):467–474. doi: 10.1016/0277-9536(92)90201-z. [DOI] [PubMed] [Google Scholar]
  11. Jennings M. C., Porter M. The changing elderly market. Top Health Care Financ. 1991 Summer;17(4):1–8. [PubMed] [Google Scholar]
  12. Lillie-Blanton M., Felt S., Redmon P., Renn S., Machlin S., Wennar E. Rural and urban hospital closures, 1985-1988: operating and environmental characteristics that affect risk. Inquiry. 1992 Fall;29(3):332–344. [PubMed] [Google Scholar]
  13. Lucas C. A., Rosenthal T. C. Access to health care in rural western New York State. N Y State J Med. 1992 Nov;92(11):465–469. [PubMed] [Google Scholar]
  14. Manton K. G. The dynamics of population aging: demography and policy analysis. Milbank Q. 1991;69(2):309–338. [PubMed] [Google Scholar]
  15. Morrisey M. A., Sloan F. A., Valvona J. Defining geographic markets for hospital care. Law Contemp Probl. 1988 Spring;51(2):165–194. [PubMed] [Google Scholar]
  16. Moscovice I. S. Rural hospitals: a literature synthesis and health services research agenda. Health Serv Res. 1989 Feb;23(6):891–930. [PMC free article] [PubMed] [Google Scholar]
  17. Newhouse J. P. Geographic access to physician services. Annu Rev Public Health. 1990;11:207–230. doi: 10.1146/annurev.pu.11.050190.001231. [DOI] [PubMed] [Google Scholar]
  18. Rice D. P., Feldman J. J. Living longer in the United States: demographic changes and health needs of the elderly. Milbank Mem Fund Q Health Soc. 1983 Summer;61(3):362–396. [PubMed] [Google Scholar]
  19. Rogers R. G., Rogers A., Belanger A. Active life among the elderly in the United States: multistate life-table estimates and population projections. Milbank Q. 1989;67(3-4):370–411. [PubMed] [Google Scholar]
  20. Roos N. P., Shapiro E., Roos L. L., Jr Aging and the demand for health services: which aged and whose demand? Gerontologist. 1984 Feb;24(1):31–36. doi: 10.1093/geront/24.1.31. [DOI] [PubMed] [Google Scholar]
  21. Shortell S. M., Gillies R. R., Anderson D. A., Mitchell J. B., Morgan K. L. Creating organized delivery systems: the barriers and facilitators. Hosp Health Serv Adm. 1993 Winter;38(4):447–466. [PubMed] [Google Scholar]
  22. Smith M. D., Robson A. M., Woodward R. S., Michelman J. E., Valerius T. J., Hong B. A. Geographic access to health care services: the case of maintenance hemodialysis. Am J Kidney Dis. 1985 Jan;5(1):19–26. doi: 10.1016/s0272-6386(85)80130-x. [DOI] [PubMed] [Google Scholar]
  23. Williams A. P., Schwartz W. B., Newhouse J. P., Bennett B. W. How many miles to the doctor? N Engl J Med. 1983 Oct 20;309(16):958–963. doi: 10.1056/NEJM198310203091606. [DOI] [PubMed] [Google Scholar]
  24. Wolinsky F. D., Coe R. M., Miller D. K., Prendergast J. M., Creel M. J., Chávez M. N. Health services utilization among the noninstitutionalized elderly. J Health Soc Behav. 1983 Dec;24(4):325–337. [PubMed] [Google Scholar]
  25. Wolinsky F. D., Coe R. M. Physician and hospital utilization among noninstitutionalized elderly adults: an analysis of the Health Interview Survey. J Gerontol. 1984 May;39(3):334–341. doi: 10.1093/geronj/39.3.334. [DOI] [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES