Changing geographic access to and locational efficiency of health services in two Indian districts between 1981 and 1996
Changing geographic access to and locational efficiency of health services in two Indian districts between 1981 and 1996
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DOI：
10.1016/j.socscimed.2003.08.019
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发表时间：
2004-05-01
影响因子：
5.4
通讯作者：
Kumar, N
中科院分区：
文献类型：
--
作者：
Kumar, N
在包括印度在内的发展中国家，私营部门在提供基本保健服务方面的作用正在逐步扩大，因为公共部门提供的服务有限，覆盖的地区也有限。本文利用区位-配置模型（LAM），（1）研究了印度西北部两个地区基本公共医疗服务维斯私人医疗服务的地理可及性和区位效率的变化，（2）询问决定其地理可达性和位置的因素-效率。虽然这项研究证实了在选定地区的公共和私人医疗服务的地理可及性和位置效率方面的区域不平等，私营卫生服务机构的区位效率明显低于公共卫生服务机构。本文进一步演示了使用LAM进行新站点识别（保持现有医疗站点的完整性），这将在未来提高这些服务的定位效率。本文不仅建议改善公共和私人卫生服务的地理可及性及其增强的补充作用，而且还强调需要从服务用户的角度评估地理可及性，并在未来的研究中使用更现实的供求数据。本文件的研究结果可以推广到具有类似地理环境、社会经济和人口条件的地区。(C)2003爱思唯尔有限公司。保留所有权利。
In developing countries, including India, the role of the private sector in the provision of basic healthcare services is gradually expanding, since the public sector provides limited services and covers only limited areas. Using location-allocation models (LAM), this paper (1) examines the changing geographic access to and locational efficiency of basic public healthcare vis-A-vis private healthcare services in two districts located in northwestern part of India, and (2) interrogates the factors that govern their geographic accessibility and locational-efficiency.Although this research confirms regional inequalities in geographic accessibility and locational efficiency of both public and private healthcare services in the selected districts, the locational efficiency of private health services is significantly lower than that of public health services. This paper further demonstrates the use of LAM for new site identification (keeping the existing healthcare sites intact) that will, in the future, improve locational efficiency of these services. This paper not only recommends improved geographic access to both public and private health services and their enhanced complementary role, but also stresses the need to evaluate geographic access from the service-users' perspective and the use of more realistic data on demand and supply in future research. The findings of this paper can be extended to areas with similar geographic settings, and socio-economic and demographic conditions. (C) 2003 Elsevier Ltd. All rights reserved.