Vägen till mödravård : En GIS-baserad loaliseringsanalys om tillgänglighet till mödravård i Norrbotten

Sammanfattning

Accessibility is an important condition for equal healthcare. The centralization of healthcare in Norrbotten county has led to longer travel times for parts of the population, thus decreasing the accessibility to maternity care. This thesis aims to examine the population’s geographical access to maternity care, as well as identifying the most suitable location for establishing new maternity care in Norrbotten county. Accessibility as a notion constitutes the theoretical framework of the thesis along with previous studies within the area. The previous studies highlight mainly the consequences of distance to maternity care for the population using it. The method used for collecting empirical data was a quantitative study using secondary data from public registers. The study was carried out using Geographic Information Systems (GIS). Accessibility was analysed through network-based travel times using the road-network in Norrbotten county. Service-areas within 90 minutes were calculated with GIS based on existing maternity care facilities to assess overall accessibility in the county. A location-allocation analysis was conducted in order to identify the most suitable location for maternity care based on accessibility. The selection was derived from the criteria that it had to be the most suitable hospital out of three existing hospitals in the county that do not currently provide maternity care. Also, suitability of a location was determined by the number of women of reproductive age who could reach the facility within 60 minutes of travel time by car. The decision of 60 minutes travel time in the location-allocation analysis was based on the large number of inhabitants within the 60 minute service-area, as well as visualizing clearer differences between the candidating hospitals. A large majority of the population has access to maternity care within 90 minutes travel time by car. Results also indicate that roughly three quarters of the population, or 177 610 people, have access to maternity care within 60 minutes by car. About a quarter of the population can be considered as having inadequate accessibility to maternity care. Furthermore, the results suggest that the most suitable location for establishing new maternity care in Norrbotten county is Kiruna Hospital, which provides the greatest access to women of reproductive age. This thesis discusses the results in relation to the theoretical framework and previous studies. The study found that travel times exceeding 60 minutes in relation to previous studies are considered inadequate accessibility. The findings suggests that a quarter of the population is considered to have inadequate accessibility, which previous studies state may contribute to increased risk for adverse perinatal outcomes and an increased political distance between the people and those in power. Furthermore, Kiruna hospital was determined as the most suitable location for establishing maternity care. Shortened travel times for the local population could in line with previous studies entail a reduced risk for distance-related consequences such as adverse perinatal outcomes.