Spatial Accessibility of Primary Care Services in Mid-Shore Maryland
Mehrnaz Ighani, Min Q. Wang, PhD.
University of Maryland, College Park, Baltimore, MD, USA.
PURPOSE: We analyzed the importance of geography and spatial behavior as enabling factors in rural health care utilization and controlling for demographic and health status factors by providing a technical report of assessment of travel to access primary care services.
METHODS: Network analysis (Google Maps API Directions Service) was used to identify the shortest driving distance and driving time by calculating the central point from each of the 60 zip code areas to the nearest primary care physician (PCP) within Kent, Queen Anne's, Caroline, Talbot, and Dorchester counties. For this report, active primary care physicians (n=110) chosen were ˂75 years of age, held a specialty board in family medicine, general practice, internal medicine, pediatrics or OB/GYN general, had an active medical license, and designated a practice in one of the counties, and provided patient care for ≥20 per week in 2014-2015. We excluded physicians working for the federal government and military.
RESULTS: The average travel distance was 9.6 miles (SD=6.8, median=8.05 miles) in the region while and average travel time was 14.9 minutes (SD=9.5, median 13.0 minutes) from the centroid of the zip code area to the nearest PCP. Based on Maryland's standard of maximum travel distance (30 miles) and maximum travel time (30 minutes) for accessing the nearest PCP, 98% of the residents travel under 15 miles and 92% of the residents travel under 30 minutes to the nearest PCP. It is also noted that the longest travel distance and time are all in the southern areas of Dorchester County.
CONCLUSION: Our results illustrate the importance of spatial behavior factors in rural health care utilization and consideration of the relationship between transportation barriers and health in addressing health care services in vulnerable environments.
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