The effect of spatial definition on the allocation of clients to screening clinics.
We compared four strategies for inviting 91,456 women aged 50-69 years to one of six clinics for mammography screening and 40,142 men aged 60-79 years to one of 10 clinics for abdominal aortic aneurysm (AAA) screening.
The strategies were invitation to the clinic nearest to the client and invitation to the clinic nearest to the client's area of residence defined by census small area, postcode and local government area.
For each strategy we calculated the expected demand at each clinic and the travel distances for clients.
We found that when women were allocated to mammography clinics on the basis of the local government area instead of their individual address, expected demand at one clinic increased by 60%, and 19% of clients were invited to attend a more remote clinic, entailing 99,000 km of additional travel.
Similar results were obtained for men allocated to AAA clinics by their postcode of residence instead of their individual address : 55% difference in expected demand, 13% to a more remote clinic and 60,000 km of extra travel.
Allocation on the basis of small areas did not show such great differences, except for travel distance, which was about 5% higher for each clinic type. (...)
Mots-clés Pascal : Mammographie, Tumeur maligne, Glande mammaire, Anévrysme, Aorte, Accessibilité, Clinique, Dépistage, Service santé, Homme, Variation spatiale, Géographie, Système santé, Australie, Océanie, Radiodiagnostic, Glande mammaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie, Artère pathologie
Mots-clés Pascal anglais : Mammography, Malignant tumor, Mammary gland, Aneurysm, Aorta, Accessibility, Clinic, Medical screening, Health service, Human, Spatial variation, Geography, Health system, Australia, Oceania, Radiodiagnosis, Mammary gland diseases, Cardiovascular disease, Vascular disease, Aortic disease, Arterial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0364477
Code Inist : 002B30A01B. Création : 12/09/1997.