The Relationship between Health Care Needs and Accessibility to Health Care Services in Botosani County- Romania

AbstractThe population's access to health care services is conditioned by the offer of medical services, which, being unevenly distributed in the country and in Botosani County, determine limited access of the population, especially in rural areas. This paper focuses on the assesing and interpretation of the population's accessibility indicators to health services and health care needs index in Botosani, in the period 2000-2013, in order to highlight the relationship between the health care needs and the accessibility to health care services. The methodology of the research consists of collecting statistical data from existing statistical online databases, as provided by the Public Health Department of Botosani, which was analyzed, processed and converted into relevant indices in order to highlight the spatial and temporal dynamics of the population's accessibility to Botosani county health resources (the health services index), to highlight the dependence of the population on health services (the health care needs index) and the population's accessibility to health resources (spatial and temporal accessibility indicators). The spatial analyse was used for mapping calculated indicators using ArcGIS software, to emphasize spatial inequalities in Botosani County. The spatial distribution of health resources, shows that the rural Botosani area is poorly covered by health services, compared to the urban area, causing a limited access of rural population to health services. The health needs index also shows that the population's dependence on health services is higher in rural areas and lower in urban areas. This outlines an inverse relationship between the two indices: the higher the health care needs are the poorer the health care services. The spatial accessibility of public health services was analyzed taking into account the average distance that the patient has to cover up to the nearest medical unit and the temporal accessibility according to the time that the patient needs in order to cover the distance to the nearest medical unit (travel time). The low accessibility of the population to health care services overlaps with urgent health care needs areas and high deprivation areas, which is reflecting on the population's health outcomes. The outlined inequalities in people's access to health services have serious consequences on the health status of population of Botosani County