Health Care Accessibility in Upper Norrland : Accessibility Profile by means of a Network Analysis

Abstract: In the temporary context of rural out-outmigration, growing agglomerations, demographic ageing andmedical advancement, the task of providing all inhabitants with sufficient health care accessibility hasbecome a challenge. Especially in rural regions like Sweden’s Upper Norrland, where the populationdensity is in most parts at a European minimum.Main aim of this thesis is elaborate and present an accessibility profile of the region Upper Norrland, incontext of medical care services. The identification of accurate individual driving times to medicalfacilities were a main goal. How Patients’ accessibility varies between different types of doctors andfacilities as well as across patients’ age groups was examined. Additionally, patients that have a drivingtime of less than 30 minutes to medical service where classified as accessible while those with longerdriving times where classified as inaccessible. The way these groups vary in socio-economic and –demographic factors was examined. The research design is a quantitative exploratory one. As method anetwork analysis was conducted on the basis of individual geo-referenced data of 2012’s inhabitants ofUpper Norrland. The main finding state, that over 80% of the population have ten minutes or less drivingtime to the next medical doctor. Half of the population can access a hospital within ten minutes or less.The share of inaccessible individuals (>30min) is small and distributed foremost dispersedly in the inland.2.8% of the population are inaccessible to Medical Doctors, 23% to hospital care. People aged 60 andabove have significantly longer driving times. Some risk factors, like age, were identified to be higher forthe inaccessible population.In conclusion, the analysed results state short driving times for the overwhelming majority in UpperNorrland. With conventional fixed facilities, the disadvantaged cannot be supplied with reasonableaccess. Same areas are moreover endangered of losing the remaining medical capabilities due tomigration and a lack of rejuvenescence. In the long run the competent planners and authorities mustinstead envisage other alternatives, like virtual, smart or mobile health care. In the rural areas, facilitiesmust be kept functioning as long as possible, especially services like maternity care, that are oftenperceived vital for the viability of rural spaces.