Measuring potential spatial access to primary health care physicians using a modified gravity model
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Ensuring equity of access to primary health care (PHC) across Canada is a continuing challenge, especially in rural and remote regions. Despite considerable attention recently by the World Health Organization, Health Canada and other health policy bodies, there has been no nation‐wide study of potential (versus realized) spatial access to PHC. This knowledge gap is partly attributable to the difficulty of conducting the analysis required to accurately measure and represent spatial access to PHC. The traditional epidemiological method uses a simple ratio of PHC physicians to the denominator population to measure geographical access. We argue, however, that this measure fails to capture relative access. For instance, a person who lives 90 minutes from the nearest PHC physician is unlikely to be as well cared for as the individual who lives more proximate and potentially has a range of choice with respect to PHC providers. In this article, we discuss spatial analytical techniques to measure potential spatial access. We consider the relative merits of kernel density estimation and a gravity model. Ultimately, a modified version of the gravity model is developed for this article and used to calculate potential spatial access to PHC physicians in the Canadian province of Nova Scotia. This model incorporates a distance decay function that better represents relative spatial access to PHC. The results of the modified gravity model demonstrate greater nuance with respect to potential access scores. While variability in access to PHC physicians across the test province of Nova Scotia is evident, the gravity model better accounts for real access by assuming that people can travel across artificial census boundaries. We argue that this is an important innovation in measuring potential spatial access to PHC physicians in Canada. It contributes more broadly to assessing the success of policy mandates to enhance the equitability of PHC provisioning in Canadian provinces .
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it