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A People-Centered GIS Analysis of Healthcare Accessibility and Quality-of-Care

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2010, Doctor of Philosophy, Ohio State University, Geography.
Geographers play important roles in public health research, particularly in understanding healthcare accessibility and individual healthcare experiences. Most geographers recognize the multi-dimensionality of accessibility, including distance to provider, cost, provider availability, service accommodation, and service satisfaction. Most accessibility studies have benefited from the increased sophistication of Geographic Information Systems (GIS) and the availability of geocoded data. Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilized individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed-methods including GIS analysis and individual data from semi-structured in-depth interviews, I offer satisfaction-adjusted distance (SAD) as a new way of conceptualizing accessibility in GIS. Based on my fieldwork in a predominantly lower-income community in Columbus, Ohio, I find that many residents felt neighborhood healthcare facilities offered low-quality care. Such comments suggested residents may have an added psychological distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure, based on individual level data, accounts for the psychological distance some residents feel as they search for high-quality healthcare in urban neighborhoods. In moving beyond conventional GIS and re-conceptualizing accessibility in this way, I offer a more realistic portrayal of the issues lower income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualizing healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare services in urban neighborhoods.
Mei-Po Kwan (Advisor)
Darla Munroe (Committee Member)
Amy Ferketich (Committee Member)
James Beatty (Other)
208 p.

Recommended Citations

Citations

  • Hawthorne, T. L. (2010). A People-Centered GIS Analysis of Healthcare Accessibility and Quality-of-Care [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1277862728

    APA Style (7th edition)

  • Hawthorne, Timothy. A People-Centered GIS Analysis of Healthcare Accessibility and Quality-of-Care. 2010. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1277862728.

    MLA Style (8th edition)

  • Hawthorne, Timothy. "A People-Centered GIS Analysis of Healthcare Accessibility and Quality-of-Care." Doctoral dissertation, Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1277862728

    Chicago Manual of Style (17th edition)