Using GIS to Unveil Distance Effects on Hospitalizations in Victoria

Abstract

In this chapter, we examine travel distance and its effect on total and avoidable hospitalizations using data from the capital health region in British Columbia, Canada. We developed a GIS procedure to connect distance-to-hospital with socioeconomic contexts of patient locations. The procedure includes geo-coding hospital locations and patient locations to determine travel distance for each hospitalization, generating several geographic barriers, such as mountain crossing, to assess their impedance, and linking patient neighborhood locations to socioeconomic variables of their locations. It was found that the overall hospitalization rates have an inverse relationship with distance-to-hospital, and living too close to a hospital may encourage utilization of hospital resources. Even though low-income patients are more likely to be hospitalized for avoidable conditions, the income effect influences different dimensions to those affected by the distance effect. Thus, it explicitly confirms the two aspects of the inverse of healthcare law that work simultaneously: those with lower socioeconomic status and those living in greater distance to hospitals tend to be less likely to access hospital care. Furthermore, the inclusion of physical barriers to our evaluation enhanced our understanding of local conditions and how they may affect hospitalizations.