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Using Geographic Information Systems to Understand Health Care Access
Robert L. Phillips, Jr, MD, MSPH;
Edward L. Kinman, PhD;
Patricia G. Schnitzer, PhD;
Erik J. Lindbloom, MD, MSPH;
Bernard Ewigman, MD, MSPH
Arch Fam Med. 2000;9:971-978.
Background Determining a community's health care access needs and testing interventions to improve access are difficult. This challenge is compounded by the task of translating the relevant data into a format that is clear and persuasive to policymakers and funding agencies. Geographic information systems can analyze and transform complex data from various sources into maps that illustrate problems effortlessly for experts and nonexperts.
Objective To combine the patient data of a community health center (CHC) with health care survey data to display the CHC service area, the community's health care access needs, and relationships among access, poverty, and political boundaries.
Design Georeferencing, analyzing, and mapping information from 2 databases.
Setting Boone County, Missouri.
Participants Community health center patients and survey respondents.
Main Outcome Measures Maps that define the CHC service area and patient demographics and show poor health care access in relation to the CHC service area, CHC utilization in relation to poverty, and rates of health care access by geopolitical region.
Results The CHC serves a distinctly different area than originally targeted. Subpopulations with unmet health care access needs and poverty were identified by census tract. These underserved populations fell within geopolitical boundaries that were easily linked to their elected officials.
Conclusions Geographic information systems are powerful tools for combining disparate data in a visual format to illustrate complex relationships that affect health care access. These systems can help evaluate interventions, inform health services research, and guide health care policy.
From the Center for Family Medicine Science, Department of Family and Community Medicine (Drs Phillips, Schnitzer, Lindbloom, and Ewigman), and the Department of Geography (Dr Kinman), University of Missouri–Columbia. Dr Phillips is now with the American Academy of Family Physicians, The Robert Graham Center: Policy Studies in Family Practice and Primary Care, Washington, DC.
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