Unit 5 Transportation & geographic access

This is the fifth unit in the module ‘GIS for Health Care Management’. The unit deals with the interaction between patients and the health care system in terms of patient travel:

1. Transport considerations
2. Definitions of accessibliity
3. Understanding patient travel
4. Representing the patient travel system
5. Generalized models – ARIA
6. Assignment

‘Definitions of accessibility’ examines the concepts underlying accessibility measurement. Accessibility involves many more factors than simple distance between the patient and the service, and may include factors such as the opening hours, languages spoken, social acceptability of services offered and the transportation available to the patient. Geographical aspects of accessibility will play an important role in this set of issues but must always be considered in context. The representation of all the appropriate factors within GIS is complex and it will generally not be possible to adquately measure and include all the elements which are known to affect accessibility in the broadest sense. This object explores some of the key aspects of accessibility which are necessary before commencing on any GIS modelling.

‘Understanding patient travel’ considers the very different patient travel scenarios which will apply in different countries and regions. These very different social realities will have an enormously important impact on any attempt to model patient accessibility to services using GIS. It is not simply a case that private car drive-time information will be appropriate in all developed countries and crow-fly distances in less developed countries with poorly developed infrastructure. The realities are much more complex, with a need to recognise that different modes of transport may be employed to reach different services and that within a population, different modes will be available to different individuals. Physical and social barriers to transport will play a major role in all contexts although the details vary. The object addresses a range of transportation including walking, travel by private car and travel by scheduled public transport services, each of which will need to be evaluated and which will require different transportation modelling strategies in GIS.

‘Representing the patient travel system’ takes the issues raised by understanding patient travel and develops GIS approaches to the handling of different types of travel information. These range from the construction of appropriate models of the barriers and routes taken by individuals travelling on foot, for whom the formal road network may be of limited use, through the development of drive-time analyses for travel by private car to the particular difficulties of incorporating public transport use into modelling, where journey scenarios are not affected only by cost and distance but by the complexities of timetabled services and the ability to change between services where no direct route can be found. Modelling accessibility by public transport generally requires a much more sophisticated handling of time than the other approaches and can present substantial difficulties when using standard GIS software.

‘Generalised models – ARIA’ takes the specific example of the Accessibility and Remoteness Index of Australia (ARIA), an example of a national accessibility index created using GIS, whose calculation involves elements of the different concepts and techniques introduced in this unit.

The final component is the assignment. The assignment is GIS-based and involves practical implementation of some of the accessibility measures addressed in this unit.

Expect to spend about 1.5 weeks working through these materials. These objects can be carried out in any order but the Assignment question should be left as the final activity. To successfully answer the assignment question, you will need to have undertaken the preceding objects and utilised the relevant learning resources.

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