Health Care : Current Reviews

Abstract

Evaluating the Spatial Mismatch Hypothesis: A Comprehensive Analysis of Access to Primary Care Physicians and Healthcare Disparities in Eastern Quebec

Christian Simoneau*

Objective: The primary objective of this study is to conduct a rigorous and comprehensive assessment of the relationship between the deficiency of medical care accessibility in rural areas, with a particular focus on the most susceptible and vulnerable segments of the population. In order to achieve this objective, the study employs the utilization of the Enhanced Two-Step Floating Catchment Area (E2SFCA) methodology, and examines its implications for the Spatial Mismatch Theory in line with the Central Place Theory. Through the application of this theoretical framework, this paper endeavors to elucidate and focus on the aforementioned deficiency, by explicating the observed incongruity between the requirements and needs of specific population segments, and the scarcity of available primary care services. By providing a detailed and nuanced analysis of these issues, this study aims to contribute to our understanding of the challenges facing rural populations in accessing essential medical care.

Method: In order to rigorously assess the validity and applicability of the Spatial Mismatch Hypothesis within the context of this investigation, a comprehensive and systematic approach was employed. This entailed the incorporation and analysis of a diverse range of data, including information pertaining to employment rates, educational attainment levels, and average commute durations, all of which were sourced from the 2016 Canadian Census. Furthermore, in order to ensure the highest degree of accuracy and reliability in our findings, an advanced two-step floating catchment area methodology was utilized as part of our analytical framework.

Results: The systematic investigation and scrutiny of the data concerning employment rates, levels of educational attainment, and average commute durations do not furnish conclusive evidence to substantiate the presence of a significant accessibility deficit among the population. Moreover, these observations serve to refute the validity of the Mismatch Spatial Hypothesis, specifically. In contrast, the Central Place Theory appears more suitable for elucidating access levels for the working population possessing a high school diploma or higher. It is apparent that the provision and accessibility of primary care services remain inextricably intertwined with, and dependent upon, the existence of sufficient road infrastructure. As a result, individuals residing at substantial distances from the primary road network may experience severely compromised access to such services.

Conclusions: This study has conducted a rigorous and comprehensive assessment of the relationship between the deficiency of medical care accessibility in rural areas, with a particular focus on the most susceptible and vulnerable segments of the population. Through the utilization of the Enhanced Two-Step Floating Catchment Area (E2SFCA) methodology, and the examination of its implications for the Spatial Mismatch Theory in line with the Central Place Theory, this paper has elucidated and shed light on the aforementioned deficiency. The findings of this study indicate that the Central Place Theory appears more suitable for elucidating access levels and that the provision and accessibility of primary care services remain inextricably intertwined with, and dependent upon, the existence of sufficient road infrastructure. As such, it is evident that individuals residing at substantial distances from the primary road network may experience severely compromised access to such services. This study has contributed to our understanding of the challenges facing rural populations in accessing essential medical care, and highlights the need for further research and policy interventions to address these issues.

Published Date: 2023-10-18; Received Date: 2023-09-18