Health, Place and Hanly: modelling accessibility to hospitals in Ireland

Abstract

The Irish Government is currently engaged in considerations about a proposed reorganisation of acute hospital services. The proposals in the 'Hanly' Report recommend the creation of new classifications of Major, General and Local Hospitals. This paper looked at how these proposals might affect geographical accessibility to Irish acute hospitals and modelled it within a GIS framework. Spatial data in the form of hospital location and size, road network and demographic distribution of over 65 's were drawn together within the GIS. A weighted accessibility formula was applied to produce a measure of accessibility called a Spatial Accessibility Measure based on travel time, hospital size and population-weighting. This measures was then applied to produce three scenarios modelled on; a) the existing configuration of services, b) a partial roll-out and c) a full roll-out of the proposed changes in the 'Hanly' Report. The scenarios identified those parts of the country, which were potentially likely to have increased/decreased accessibility to acute hospital services based on the different scenarios. Residents in the central and western parts of the country were shown to be most vulnerable, while the impacts of a full roll-out of Hanly suggests additional potential impacts on some suburban hospitals in the Greater Dublin area. The work provides a valuable and previously underdeveloped set of policy-informed spatial outcomes which can be adjusted if or when more beds are introduced into the Irish health care system in the next five to ten years.