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Title
Deprivation, healthcare accessibility and satisfaction : geographical context and scale implications
AuthorCabrera-Barona, Pablo ; Blaschke, Thomas ; Gaona, Gabriel
Published in
Applied Spatial Analysis and Policy, Amsterdam : Springer Netherlands, 2017, Vol. 2017, Issue [online first], page 1-20
LanguageEnglish
Document typeJournal Article
Keywords (EN)Modifiable areal unit problem (MAUP) / Uncertain geographic context problem (UGCoP) / Neighborhood effects / Deprivation / Healthcare accessibility / Healthcare satisfaction
ISSN1874-4621
URNurn:nbn:at:at-ubs:3-3940 Persistent Identifier (URN)
DOI10.1007/s12061-017-9221-y 
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 The work is publicly available
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Deprivation, healthcare accessibility and satisfaction [3.35 mb]
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Abstract (English)

Indices explaining health phenomena are important tools for identifying and investigating health inequalities and to support policy making. Some of these indices are expressed at area-level, and the investigation of the areal influences of these indices on individual health outcomes have scale and geographical contextual implications that need to be assessed. In this study we calculated two area-level indices: one deprivation index and one index of healthcare accessibility. Using multilevel modelling, we calculated the area-level influences of these indices on an individual-level index of healthcare satisfaction considering three kinds of areas or contexts: a context of deprivation, a context of healthcare accessibility and a context combining the two characteristics of healthcare accessibility and deprivation. We evaluated two kinds of geographical problems using the statistical results of these area-level influences: the modifiable areal unit problem (MAUP) and the uncertain geographic context problem (UGCoP). Regarding the MAUP we evaluated the scale effects at two scales: census blocks and census tracts. Regarding the UGCoP we evaluated the differences in areal influences between the three kinds of contexts for both scales. The case study area was the city of Quito, Ecuador. The results of the performed analyses showed no severe MAUP and UGCoP, and revealed important evidence of the area-level influence of deprivation and healthcare accessibility on healthcare satisfaction.

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CC-BY-License (4.0)Creative Commons Attribution 4.0 International License