Improving the Evaluation of Primary Care Physician Accessibility in Eastern Quebec: Incorporating the Pampalon Deprivation Index into the Enhanced Two-Step Floating Catchment Area Methodology

Abstract

Christian Simoneau*

Objective: To improve the Enhanced Two-Step Floating Catchment Area (E2SFCA) method by incorporating the Pampalon Deprivation Index (PDI). This integration will enable the characterization of the local environment and the identification of primary care accessibility patterns in Eastern Quebec that may not be detected by traditional physician access measures.

Methods: We used the Pampalon Deprivation Index (PDI) to adjust the access ratio of Primary Care Physicians (PCPs) calculated by the enhanced two-step floating catchment area method. This approach considers the supply of PCPs at the dissemination area level, travel time between PCPs and dissemination areas and a linear distance decay function (β) in conjunction with the PDI for each dissemination area. The PDI is a composite measure of material and social deprivation, which can help to identify vulnerable populations who may face barriers to accessing healthcare services.

Results: The E2SFCA method with the PDI adjustment (E2SFCA-PDI) can identify underserved areas that may appear to have sufficient access levels when evaluated using the E2SFCA method alone. The accessibility of primary care services depends on the availability of adequate road infrastructure. Populations living in areas with limited access to main road networks may have compromised access to primary care. This issue disproportionately affects vulnerable individuals who lack private transportation options.

Conclusion: The E2SFCA-PDI method can improve the identification of primary care physician shortage areas by taking into account the health needs of the population. Moreover, it can inform the development of regional medical planning and resource allocation, thereby contributing to a more equitable and just society.