A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study
OBJECTIVE To evaluate spatial access to mammography clinics and to investigate whether relocating clinics can improve global access. To determine whether any change in access is distributed equitably between different social groups. METHODS The study was undertaken in Perth, Western Australia in 1996. It was an analysis of travel distances to mammography clinics, comparing distances to the pattern of existing clinics and modelled relocated clinics. The study population was the 151,162 women aged 40-64 years resident in Perth in 1991. RESULTS Overall travel distances to the existing clinics was reduced by 14% when a GIS system was used to relocate them so as to minimise the travel distance for all women. The travel distance of the most disadvantaged groups fell by 2% and by 24% for the least disadvantaged group. CONCLUSIONS GIS modelling can be used to advantage to evaluate potential locations for screening clinics that improve the access for the target population, however global analysis should be supplemented by analysis of special groups to ensure that no group is disadvantaged by the proposal. IMPLICATIONS If new technology is not used to evaluate the placement of health services, population travel distances may be greater than necessary, with possible impacts on attendance rates.