An Analysis of the Proximity Based Polarisation of the Hospital Network of Moldavia’s Counties
Keywords:
hospital network, medical services, health care system, Thiessen polygons, Medical Geography, Moldavia, RomaniaAbstract
Since 1990, the deficiencies of the widely criticised health care system of Romania have been analysed from economic, political and management related points of view, but the territorial dimension of this system was often neglected. Identifying and understanding the shaping role of the spatial dimension are the prerequisites of any effective and compelling implementation of change. This paper aims to analyse the hospital network in Moldavia’s counties from the geographic proximity based influence point of view. The polarisation areas of territorial, emergency and specialised (pneumology and phthisiology, psychiatric) hospitals are generated as Thiessen proximal polygons. These geometric constructions help to determinate the locations that are the closest to a particular hospital, which proves to be useful in medical emergency situations, but also when distance becomes an important restrictive factor – as in the case of vulnerable population with limited financial resources, scarce mobility opportunities or constraints imposed by age. The hospital network may be considered the backbone of the medical system and its spatial distribution should be taken into account as an important shaping factor. This paper offers a regional approach of this matter, which can be used for planning bottom-up improvement strategies.
References
BEN-SHLOMO Y., CHATURVEDI N., 1995. Assessing equity in access to health care provision in the UK: does where you live affect your chances of getting a coronary artery bypass graft?, Journal of Epidemiology & Community Health, 49(2), 200-204
BOSCHMA R., 2005. Proximity and Innovation: A Critical Assessment, Regional Studies, 39(1), 61-74
CIUTAN M., CHIRIAC N.D., 2009. The territorial distribution and use of emergency hospitals - Romania, 2007 -, Management in Health (1), 66-72
CORDASCO K.M., PONCE N.A., GATCHELL M.S., TRAUDT B., ESCARCE J.J., 2011. English language proficiency and geographical proximity to a safety net clinic as a predictor of health care access, Journal of Immigrant and Minority Health, 13(2), 260-267
DOBRIN A., 2005. A review of properties and variations of Voronoi diagrams, Whitman College, http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.453.9156&rep=rep1&type=pdf
DRAGOMIRIȘTEANU A., 2010. Reducing inequities in healthcare: a priority for European policies and measures, Management in Health , 14 (3), 14-19
DUMITRACHE L., DUMBRĂVEANU D., 2008. Geographic distribution of sanitary resources in Romania and its consequences on individual and public health, Human Geography, Journal of Studies and Research in Human Geography, 51-60, http://humangeographies. org. ro/articles/22/Dumitrache. pdf
DUMITRACHE L., NAE M., DUMBRAVEANU D., SIMION G., SUDITU B., 2016. Contrasting Clustering in Health Care Provision in Romania: Spatial and Aspatial Limitations, Procedia Environmental Sciences, 32, 290-299
EVA M., IAȚU C., 2015. Modelling spatial accessibility to medical care. Case study of the North-Eastern Region of Romania, Human Geographies: Journal of Studies and Research in Human Geography, 9(2), 151-164
FARCASANU D.O., 2010. Population perception on corruption, informal payments and introduction of co-payments in the public health system in Romania, Management in Health, 14 (1), 8-13
JANKAUSKIENE D., JANKAUSKAITE I., 2011. Access and quality of health care system by opinion of patients in ten European countries, Management in Health, 15 (3), 31-39
KARANIKOLOS M., MCKEE M., 2011. How well is the Romanian health system performing? - Some progress but still some way to go -, Management in Health , 15 (1), 4-7
Law no. 95/2006. Official Journal of Romania
MARECI A., 2008. The Degree of Accessibility to Health Care–Issues Concerning the North-Eastern Population of Romania, Human Geographies: Journals of Studies and Research in Human Geography, 2(1), 43-53
OLIVER A., MOSSIALOS E., 2004. Equity of access to health care: outlining the foundations for action, Journal of Epidemiology & Community Health, 58(8), 655-658
SUCIU M.C., STAN C.A., PICIORUȘ L., IMBRIȘCĂ C.I., 2012. The Post-Crisis Healthcare System: Effects of the Economic Crisis in Romania, Theoretical & Applied Economics, 19 (5), 157-168
TANSER F., GIJSBERTSEN B., HERBST K., 2006. Modelling and understanding primary health care accessibility and utilization in rural South Africa: an exploration using a geographical information system, Social science & medicine, 63(3), 691-705
THE MINISTRY OF HEALTH OF ROMANIA (2014). The list of public hospitals of Romania by regions [online] Available at: http://data.gov.ro/dataset/lista-spitalelor-publice/resource/0f076462-a72e-4b2d-ab24-1df4c7f26f2f?inner_span=True [Accessed: 10 Aug. 2018].
THE NATIONAL INSTITUTE OF STATISTICS (2016). Medical personnel by categories, forms of property, genders, macroregions, development regions and counties [online] Available at: http://statistici.insse.ro/shop/index.jsp?page=tempo2&lang=ro&context=30 [Accessed: 10 Aug. 2018].
THIESSEN A.H., 1911. Precipitation averages for large areas. Climatological data for July, 1911, Monthly Weather Review, 1082-1084
TORRE A., GILLY J.P., 2000. On the Analytical Dimension of Proximity Dynamics, Regional Studies, 34(2), 169-180
URSULICA T.E., 2016. The relationship between health care needs and accessibility to health care services in Botosani county- Romania, Procedia Environmental Sciences, 32, 300-310
VLĂDESCU C., SCÎNTEE S.G., OLSAVSZKY V., HERNÁNDEZ-QUEVEDO C., SAGAN A., 2016. Health systems in transition: Romania: health system review in Health systems in transition, 18(4)
YAMADA I., 2016. Thiessen polygons in The International Encyclopedia of Geography, Edited by Douglas Richardson (Ed.). John Wiley & Sons, Ltd., 350-359
