Unit 2 Concepts in spatial healthcare planning
This is the second unit in the module ‘GIS for Health Care Management’ which deals with spatial aspects of health care planning. This unit focuses on understanding different aspects of the spatial organization of the health care system. There is a perennial tension in health care delivery between specialization and accessibility, whereby the most advanced health services are highly technological, requiring expensive equipment and highly trained staff. It is not possible to deliver these types of services at anything more than a few specialist centres, but this inevitably leads to unequal access based on geographical location. By contrast, the most basic health care services which provide health education, vaccination and immunization programmes and basic emergency care need to be highly dispersed in order to achieve a high degree of effectiveness. When planning the delivery of any health care service there is therefore a strong tension between the provision of the highest standard of specialist services and the provision of basic care close to the population being served. This tension underlies most of the issues addressed in this unit, which are as follows:
- Principles of spatial organization and efficiency
- Geographical accessibility and specialisation
- Inverse care law
- Market areas, catchment populations
- Population denominators, service provision and usage
‘Principles of spatial organization and efficiency’ considers the geographical factors which affect the efficiency of health care. It examines different organizational models for health care and considers what constitutes efficiency in the delivery of health care services.
‘Geographical accessibility and specialisation’ looks in more detail at the tension between medical specialization and community-oriented services. It reviews the different elements of accessibility including not geographical factors, and explores the tension between offering specialist services at central locations and offering locally-based services which may play an important role in preventive medicine but cannot deliver high-tech services.
The ‘inverse care law’ relates to the frequent occurence that those geographical regions with the most needy populations have poorest access to health care services. The extent to which the health care planner is concerned to address this pervasive inequality will be determined by the nature of the health care system, but there is a distinct role for spatial analysis and GIS in assessing the match between service provision and population need.
‘Market areas, catchment populations’ considers the factors which influence the definition of populations served by specific health care facilities, which may in some systems be conceptualised as ‘market areas’ and in other, more welfare-oriented systems as ‘catchment populations’. These operate at different scales corresponding to the different levels of the health care system and will frequently overlap extensively.
‘Population denominators, service provision and usage’ considers the type of data required to support GIS-based health care management or planning. Here you will explore the range of data available.
Expect to spend about 1 week working through these materials. These objects can be carried out in any order but the Assignment 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.