Background: Geographical accessibility is important in accessing healthcare services. Measuring it has evolved alongside technological and data analysis advances. High correlations between different methods have been detected, but no comparisons exist in the context of palliative and end of life care (PEoLC) studies. To assess how geographical accessibility can affect PEoLC, selection of an appropriate method to capture it is crucial. We therefore aimed to compare methods of measuring geographical accessibility of decedents to PEoLC-related facilities in South London, an area with well-developed SPC provision. Methods: Individual-level death registration data in 2012 (n = 18,165), from the Office for National Statistics (ONS) were linked to area-level PEoLC-related facilities from various sources. Simple and more complex measures of geographical accessibility were calculated using the residential postcodes of the decedents and postcodes of the nearest hospital, care home and hospice. Distance measures (straight-line, travel network) and travel times along the road network were compared using geographic information system (GIS) mapping and correlation analysis (Spearman rho). Results: Borough-level maps demonstrate similarities in geographical accessibility measures. Strong positive correlation exist between straight-line and travel distances to the nearest hospital (rho = 0.97), care home (rho = 0.94) and hospice (rho = 0.99). Travel times were also highly correlated with distance measures to the nearest hospital (rho range = 0.84-0.88), care home (rho = 0.88-0.95) and hospice (rho = 0.93-0.95). All correlations were significant at p < 0.001 level. Conclusions: Distance-based and travel-time measures of geographical accessibility to PEoLC-related facilities in South London are similar, suggesting the choice of measure can be based on the ease of calculation.
Bibliographical noteFunding Information:
We thank the data providers for this work: Office for National Statistics (ONS), the Health and Social Care Information Centre (HSCIC), Care Quality Commission (CQC), the National Council for Palliative Care (NCPC), the London Cancer Alliance (LCA), Transport for London (TfL - Powered by TfL Open Data), Ordnance Survey data - © Crown Copyright and Database Right 2015. Ordnance Survey (Digimap Licence). The Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London is part of the National Institute for Health Research (NIHR), and is a partnership between King’s Health Partners, St. George’s, University London and St George’s Healthcare NHS Trust. Guide_Care Services project is a large scale observational study investigating the role of service factors in place of death funded by the National Institute for Health Research, Health Services and Delivery Research Programme (NIHR HS & DR, 14/19/22), led by King’s College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK. This is independent research jointly funded by the NIHR CLAHRC South London and the NIHR HS & DR Guide_Care Services. The views expressed in this publication are those of the author (s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
© 2017 The Author(s).
- Geographical accessibility
- Health services
- Palliative care