Distance and socioeconomic status as a health service predictor on the periphery in the southern region of Israel

This research focuses on the accessibility of health-services to the population in the southern region of Israel, comparing accessibility within the periphery. The objective was to study whether there is a correlation between the number of patient visits to specialist-clinics to the geographical distance from the patient's home and the patient's socioeconomic-status. The population of the study was patients insured by the Clalit HMO, the major health-provider on the periphery in Israel's southern region who visited the Soroka University Medical Center's (SUMC) out-patient specialist-clinics between 2000 and 2005. The specialist-clinics in the study were divided into five categories: (1) pediatrics (2) orthopedics (3) audio lab (4) sleep lab; (5) geriatrics. The dependent-variable-the number of patients' visits to clinics was analyzed (parametric and non-parametric) according to a set of independent variables: (1) population size, (2) age-distribution (3) gender (4) size of family, (5) vehicles per household, (6) socioeconomic level (by percentiles) (7) distance from the Beer-Sheva (site of the SUMC clinics) in terms of concentric geographical rings (distance and time-travel). Results show that the distance from Beer-Sheva and the socioeconomic level of patients' town (by percentiles) has a negative correlation to the number of visits. That is, patients who live further away or are from higher socio-economical percentiles, frequent specialist-clinics less. In order to be effective (equality of availability and accessibility), a health system in the periphery must build programs that take into consideration the needs of specific localities, such as distance to the health services, and the patient's socioeconomic level.Rural health Periphery Socio-economical level Accessibility of health care Availability of health services