A MCDA/GIS-Based Approach for Evaluating Accessibility to Health Facilities

Abstract

Access to health care services is a key concept in the formulation of health policies to improve the population’s health status and to mitigate inequities in health. Previous studies have significantly enhanced our understanding and knowledge of the role played by spatial distribution of health facilities in sustaining population health, with extensive research being devoted to the place-based accessibility theory, with special focus on the gravity-based methods. Although they represent a good starting point to analyse disparities across different regions, the results are not intelligible for policy-making purposes. Given the weaknesses of these methods and the multidimensional nature of the topic, this study intends to: (i) highlight the main measurements of access and their major challenges; and (ii) propose a framework based on multiple criteria decision analysis methods and GIS to appraise the population’s accessibility to health facilities. In particular, this framework is based on a new variant of the UTASTAR method, which requires decision makers and/or experts preference information, in the form of an ordinal ranking, similarly to the UTASTAR method, but to which cardinal information is also added. A numerical example is presented to illustrate the application of the proposed methodology.