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Palliative care and proximity to services

The ability to physically reach facilities such as a hospitals, hospices and care homes is obviously a hugely important part of palliative care service provision, and a clear determinant of healthcare usage.

Research into accessibility is valuable to policymakers and commissioners as improved service organisation can lead to improved efficiency and equality of care. Several methods for quantifying geographical accessibility to health services exist, ranging from the rudimentary, such as straight-distance measurements, to the more sophisticated, such as measurement of travel times or travel distances.  Findings from previous studies have shown that a high degree of similarity exists amongst these methods. However, comparisons of these methods in the context of end of life care have not previously been explored.

In a recent study, published in BMC Palliative Care, researchers from the Cicely Saunders Institute compared three commonly used techniques for quantifying geographical accessibility (i.e. measuring travel distances, measuring straight line distances and using a ratio-based method). Comparisons of the techniques were based on a case study of quantifying geographical accessibility to a range of palliative care services (based in hospitals, hospices and care homes) in South London.

The findings from this study indicate that using straight-line distances to quantify geographical accessibility yields similar results to the measurement of travel time or distance. This means that non-experts in the area of Geographical Information Science can use simple methods at their disposal. The challenge of using sophisticated techniques to measure distance can no longer be considered a barrier to research into healthcare services and accessibility.

In addition to their recent study, the research team is currently conducting a national analysis to understand the relationship between distance to healthcare facilities and place of death. Clearly the physical proximity of patients to the services that they use will continue to shape the direction of future palliative care research.

For more information about the study, the full paper can be accessed here: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-017-0185-0