Is neighborhood access to health care provision associated with individual-level utilization and satisfaction?

Objective. To explore whether travel time access to the nearest general practitioner (GP) surgery (which is equivalent to U.S. primary care physician [PCP] office) and pharmacy predicts individual-level health service utilization and satisfaction.

Data Sources. GP and pharmacy addresses were obtained from the New Zealand Ministry of Health in 2003 and merged with a geographic boundaries data set. Travel times derived from these data were appended to the 2002/03 New Zealand Health Survey (N=12,529).

Study Design. Multilevel logistic regression was used to model the relationship between travel time access and five health service outcomes: GP consultation, blood pressure test, cholesterol test, visit to pharmacy, and satisfaction with latest GP consultation.

Data Collection/Extraction. Travel times between each census meshblock centroid and the nearest GP and pharmacy were calculated using Geographical Information System.

Principal Findings. When travel times were long, blood pressure tests were less likely in urban areas (odds ratio [OR] 0.75 [0.59–0.97]), GP consultations were less likely in rural centers (OR 0.42 [0.22–0.78]) and pharmacy visits were less likely in highly rural areas (OR 0.36 [0.13–0.99]). There was some evidence of lower utilization in rural areas.

Conclusions. Locational access to GP surgeries and pharmacies appears to sometimes be associated with health service use but not satisfaction.