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Article

Rural–Urban Disparities in Realized Spatial Access to General Practitioners, Orthopedic Surgeons, and Physiotherapists among People with Osteoarthritis in Alberta, Canada

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Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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McCaig Bone and Joint Health Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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O’Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada
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Applied Research and Evaluation Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
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Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Department of Geography, University of Calgary, Calgary, AB T2N 1N4, Canada
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Department of Civil Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
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Department of Environmental Science and Policy, College of Science, George Mason University, Fairfax, VA 22030, USA
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Author to whom correspondence should be addressed.
Academic Editors: Rosa Urbanos-Garrido and Alexandrina Stoyanova
Int. J. Environ. Res. Public Health 2022, 19(13), 7706; https://doi.org/10.3390/ijerph19137706
Received: 14 April 2022 / Revised: 11 June 2022 / Accepted: 19 June 2022 / Published: 23 June 2022
(This article belongs to the Special Issue Equity, Access and Use of Health Care Services)
Rural Canadians have high health care needs due to high prevalence of osteoarthritis (OA) but lack access to care. Examining realized access to three types of providers (general practitioners (GPs), orthopedic surgeons (Ortho), and physiotherapists (PTs)) simultaneously helps identify gaps in access to needed OA care, inform accessibility assessment, and support health care resource allocation. Travel time from a patient’s postal code to the physician’s postal code was calculated using origin–destination network analysis. We applied descriptive statistics to summarize differences in travel time, hotspot analysis to explore geospatial patterns, and distance decay function to examine the travel pattern of health care utilization by urbanicity. The median travel time in Alberta was 11.6 min (IQR = 4.3–25.7) to GPs, 28.9 (IQR = 14.8–65.0) to Ortho, and 33.7 (IQR = 23.1–47.3) to PTs. We observed significant rural–urban disparities in realized access to GPs (2.9 and IQR = 0.0–92.1 in rural remote areas vs. 12.6 and IQR = 6.4–21.0 in metropolitan areas), Ortho (233.3 and IQR = 171.3–363.7 in rural remote areas vs. 21.3 and IQR = 14.0–29.3 in metropolitan areas), and PTs (62.4 and IQR = 0.0–232.1 in rural remote areas vs. 32.1 and IQR = 25.2–39.9 in metropolitan areas). We identified hotspots of realized access to all three types of providers in rural remote areas, where patients with OA tend to travel longer for health care. This study may provide insight on the choice of catchment size and the distance decay pattern of health care utilization for further studies on spatial accessibility. View Full-Text
Keywords: osteoarthritis; realized access; travel time; general practitioners; orthopedic surgeons; physiotherapists; distance decay; rural–urban osteoarthritis; realized access; travel time; general practitioners; orthopedic surgeons; physiotherapists; distance decay; rural–urban
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MDPI and ACS Style

Liu, X.; Seidel, J.E.; McDonald, T.; Patel, A.B.; Waters, N.; Bertazzon, S.; Shahid, R.; Marshall, D.A. Rural–Urban Disparities in Realized Spatial Access to General Practitioners, Orthopedic Surgeons, and Physiotherapists among People with Osteoarthritis in Alberta, Canada. Int. J. Environ. Res. Public Health 2022, 19, 7706. https://doi.org/10.3390/ijerph19137706

AMA Style

Liu X, Seidel JE, McDonald T, Patel AB, Waters N, Bertazzon S, Shahid R, Marshall DA. Rural–Urban Disparities in Realized Spatial Access to General Practitioners, Orthopedic Surgeons, and Physiotherapists among People with Osteoarthritis in Alberta, Canada. International Journal of Environmental Research and Public Health. 2022; 19(13):7706. https://doi.org/10.3390/ijerph19137706

Chicago/Turabian Style

Liu, Xiaoxiao, Judy E. Seidel, Terrence McDonald, Alka B. Patel, Nigel Waters, Stefania Bertazzon, Rizwan Shahid, and Deborah A. Marshall. 2022. "Rural–Urban Disparities in Realized Spatial Access to General Practitioners, Orthopedic Surgeons, and Physiotherapists among People with Osteoarthritis in Alberta, Canada" International Journal of Environmental Research and Public Health 19, no. 13: 7706. https://doi.org/10.3390/ijerph19137706

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