Overview

Abstract (English)

As healthcare is a right in Canada, analyzing the distribution of spatial access to medical consultations, which are crucial for the prevention, diagnosis and early treatment of illnesses, is fundamental to understanding health equity. Spatial accessibility can influence whether individuals can reasonably reach the services they seek. However, as an indicator of potential access, it does not guarantee realized access due to predisposing and need factors. This study examines the relationship between spatial accessibility to hospitals and the likelihood of consulting with a healthcare professional at a hospital in eight Canadian metropolitan regions while controlling for individual characteristics through multilevel regression modelling. Spatial accessibility was computed using the two-step floating catchment area (2SFCA) method. Self-reported consultations and socio-demographic characteristics were obtained from the Canadian Community Health Survey. We found that the likelihood of consultations differed between genders (female OR: 1.133, CI: 1.023-1.255; compared to male), followed a positive household income gradient (high-income OR: 1.236 CI: 1.094-1.397; middle-income OR: 1.039 CI: 0.922-1.172; compared to low-income) but is not influenced by age. Living in areas with higher spatial accessibility was positively linked to consultations (OR: 1.014 CI: 1.000-1.028), even after controlling for perceived health (OR: 0.540 CI: 0.471-0.621), chronic conditions (OR: 1.738 CI: 1.587-1.904) and having a regular doctor (OR: 1.313 CI: 1.187-1.452). Policies that may improve spatial accessibility to healthcare services through increasing supply, managing demand and enhancing level of public transport service should be considered to improve individuals’ ability to consult healthcare professionals, potentially leading to better health outcomes.

Abstract (French)

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