Evolution of geographic access to hospital surgery in France between 2000 and 2018: analysis of socio-spatial inequalities.

Keywords: access, surgery, hospital, urban system, city, France,
Session Type: Virtual Paper Abstract
Day: Sunday
Session Start / End Time: 2/27/2022 03:40 PM (Eastern Time (US & Canada)) - 2/27/2022 05:00 PM (Eastern Time (US & Canada))
Room: Virtual 40

Abstract

In France, the implementation of various hospital reforms and technological transformations since the 2000s has had significant spatial consequences on hospital geography. Between 2000 and 2018, the disappearance of approximately 39,000 surgical beds in metropolitan France was observed. The objective of this presentation is to measure the consequences of these disappearances on geographic access. Our main hypothesis is that the closure of surgical beds has led to an increase in inequalities between town sizes (small vs. large) between territories (rural vs. urban) and also between populations (executive vs. worker).

The method for calculating geographic access times to hospitals equipped with surgical beds in 2000 and 2018 at the level of continental France is based on the mobilisation of a main database: the public database of the SAE (Statistique Annuelle des Etablissements) which provides the locations of surgical structures at these two dates. Access times are calculated from the free OSMR (Open Source Routing Machine) platform, from each municipality to the two closest hospitals.

The results show spatial and social differences. The increase in access times is more pronounced for people living in small towns and cities on the periphery of departments and regions. As an example, 90% of the population of the urban areas had access to surgery in less than 15 mn, but only 37% of suburban population. Regarding the populations, the increase in access times was much more important for working class populations than for executives, regardless of the type of residence area.