Variability of geographical accessibility to healthcare facilities that provide general practice and primary mental healthcare services

The aim of the study was to calculate and compare indices of geographical accessibility to primary healthcare facilities in various levels of administrative territories in Lithuania. Material and methods. We combined several layers of spatial data to calculate total accessibility indicator (TAI) to primary healthcare facilities. The spatial data contained point layer with healthcare facilities where general practice and primary mental healthcare serviced were provided. Layers with number of residents in 1 km grids were also used. TAI was calculated for elderships, municipalities and regions and compared among different levels of administrative territories. Results. There were 731 geographical locations in Lithuania in 2016 where general practice and/or primary mental healthcare services were provided. General practice services were provided in 694 locations, primary mental healthcare services – in 148 locations. TAI value for general practice services calculated by linear distance was 445.6 (out of 500). TAI value for general practice services calculated by travel time by car was 292.3 (out of 300). TAI value for primary mental healthcare services was 347.3 (out of 500). Population in Tauragė and Utena regions had the lowest geographical accessibility to general practice services – TAI values calculated by linear distance were 409 and 408 out of 500 respectively, and TAI values calculated by travel time by car were 286 out of 300. Population in Tauragė region had the lowest geographical accessibility to primary mental healthcare (TAI value was 253 out of 500). When comparing TAI values in municipalities and elderships, the lowest TAI values were estimated in municipalities of Šalčininkai, Švenčionys, Zarasai and Ignalina (or in elderships in these municipalities). Conclusions. The level of administrative territories should be taken into consideration when analysing geographical accessibility, because different strategies of research may lead to different conclusions