Distance to Physicians

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Distance to Physicians? Access to health services depends on many factors, including:

• the presence/absence of a health care facility (for example, a hospital)
• the presence/absence of health care personnel (for example, nurses or physicians)
• the capacity/ability of a health care facility or an individual health care provider to actually provide service
• the distance a person has to travel to access health services

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Measuring Distance to Nearest Medical Personnel

Distance may be measured in terms of cost or the time it takes a person to travel to a health care facility or to the location of health care personnel. Or, a measure of the psychological barrier of distance may be used. But none of these measures are available at the present time in datasets that would provide consistent or standard information for this country-wide analysis. Instead, the more commonly used "straight line" or "as the crow flies" distances have been computed for a number of health care professionals and facilities. This approach is not new. In Canada, some of the most frequently cited examples of this procedure include the work of Angus and Brothers (1976), Ng et al. (1993, 1997 and 1999), and Pitblado and Pong (1999).

Using the procedure outlined by Ng et al. (1993 and 1997), several distance measurements were computed for the Rural Health issue reported here:

From:

The geographical locations of the Canadian population at each of 49 361 enumeration areas expressed in terms of latitude and longitude. (Data Source: Statistics Canada.)

To:

The nearest geographical location expressed in terms of enumeration area latitude and longitude of each of the physician types listed below. (Data Source: 1998 Southam Medical Database of the Canadian Institute for Health Information.)

a) Family physician
b) Physician specialist (i.e. not differentiated by speciality)
c) Physician specialists differentiated by the following specialties:

• internal medicine
• pediatrics
• psychiatry
• anesthesia
• diagnostic radiology
• general surgery
• obstetrics and gynecology
• orthopedic surgery

In this analysis, a population-to-physician distance was not measured if the physician type or category was not in the same province/territory as the population site or location. Each of these distance measures was then averaged for each of the physician types for each of the 288 census divisions in Canada.

Graphical summaries of the average distances to the physician categories below (Figures 1 to 8) are provided using the urban/rural categories defined by the Organization for Economic Co-Operation and Development (OECD) system. These summaries are provided for information purposes, without commentary as they are reasonably self explanatory.

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Figure 1. Average Distance to the Nearest Specialist in Internal Medicine, 1998

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Figure 2. Average Distance to the Nearest Specialist in Pediatrics, 1998

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Figure 3. Average Distance to the Nearest Specialist in Psychiatry, 1998

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Figure 4. Average Distance to the Nearest Specialist in Anesthesia, 1998

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Figure 5. Average Distance to the Nearest Specialist in Diagnostic Radiology, 1998

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Figure 6. Average Distance to the Nearest Specialist in General Surgery, 1998

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Figure 7. Average Distance to the Nearest Specialist in Obstetrics & Gynecology, 1998

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Figure 8. Average Distance to the Nearest Specialist in Orthopedic Surgery, 1998

Similar graphical summaries and census division maps are provided for the average distances to the nearest family physician and the nearest physician specialist.