ACCESSIBILITY ANALYSIS OF HEALTH CARE FACILITIES IN

GEELONG, VICTORIA AUSTRALIA

INDIKA PRASAD WIJAYAMANNA

MSc 2016
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ACCESSIBILITY ANALYSIS OF HEALTH CARE FACILITIES IN

GEELONG, VICTORIA AUSTRALIA

A PROJECT REPORT PRESENTED BY

INDIKA PRASAD WIJAYAMANNA

To the Board of Study in Earth Sciences of the

POSTGRADUATE INSTITUTE OF SCIENCE

In partial fulfilment of the requirements

for the award of the degree of

MASTER OF SCIENCE IN GIS AND REMOTE SENSING

of the

UNIVERSITY OF PERADENIYA

SRI LANKA

2016
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DECLARATION

I do hereby declare that the work reported in this research project report was exclusively
carried out by me under the supervision of Mr. S. Sivanantharajah, Senior Superintendent
of Surveys Department of Sri Lanka and Dr. Jagath Gunatilake, Department of Geology,
University of Peradeniya. It describes the results of my own independent research except
where due reference has been made in the text. No part of this research project report has
been submitted earlier or concurrently for the same or any other degree.

Date : .
Signature of the candidate

Certified by:

1. Supervisor: Mr. S. Sivanantharajah Date

Signature: ..

2. Supervisor: Dr. Jagath Gunatilake Date

Signature: ..

PGIS Stamp
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ACCESSIBILITY ANALYSIS OF HEALTH CARE FACILITIES IN

GEELONG, VICTORIA AUSTRALIA

I.P. Wijayamanna

Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka

Department of Geology, University of Peradeniya, Peradeniya, Sri Lanka

Access to health care facilities is considered as a basic right of all human being in the
modern world. Adequate and affordable access to health care facilities by local
communities in urban and rural areas is an important issue of human service provision to
both public policy makers and urban planners. Minimising time taken to get to right health
care facilities is often considered one of the main objectives of many health care systems.
Due to spatial variations in population distribution, transportation infrastructure as well as
distribution of health care facilities, there exists spatial variation in accessibility to the
health care facilities and locations where accessibility to health care facilities is poor.

Geographic Information System (GIS) is a combination of computer software, hardware,

spatial and non-spatial data, internet facilities and various devices such as Global Position
System (GPS) which can be used to analyse or study issues which has geographic
information involved. In modern world GIS are widely used as planning, monitoring and
decision making tool.

This research aims to study accessibility to health care facilities with GIS analysis of the
area Geelong region in Victoria. Road network, location of health care services,
distribution of population and their income level would be spatially analysed and identify
areas based on the variation of accessibility to health care facilities
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TABLE OF CONTENTS
CH
APTER
Page
Declaration ii
Abstract iii
Table of Contents iv
List of Tables vi
List of Figures vii
List of Appendices viii
List of Abbreviations ix

1 INTRODUCTION
1.1 BACKGROUND 1
1.2 STUDY AREA 2
1.2.1 Population Size and Growth 2
1.2.2 Land use 3
1.3 HEALTH SYSTEM 4
1.4 PROBLEM STATEMENT 4
1.5 OBJECTIVE 4
1.6 SIGNIFICANCE OF THE STUDY 5

2 LITERATURE REVIEW
2.1 INTRODUCTION 6
2.2 ACCESS 6
2.3 SPATIAL ACCESSIBILITY 8
2.4 INDICATOR/MEASURES OF SPATIAL ACCESSIBILITY 8

3 RESEARCH METHODOLOGY
3.1 INTRODUCTION 12
3.2 RESEARCH DESIGN 12
3.4 RESEARCH STRATEGY AND TECHNIQUES 13
3.5 CREATING DATABASE 13
3.5.1 Collection and Organisation of data 13
3.5.2 Material and equipment used 16
3.5.3 Software used 16
3.5.4 Population identification 17
3.5.5 Road Network 19
3.6 ANALYSIS OF ROAD NETWORK 20
3.6.1 Mapping of health care facilities and population
distribution and road system 20
3.6.2 Create network datasets 20
3.6.3 Analysis of road network 20
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4 RESULTS AND DISCUSSION

4.1 INTRODUCTION 22
4.2 ACCESSIBILITY TO HEALTH CARE FACILITIES 22
4.2.1 Accessibility to maternal &child care centres 23
4.2.2 Accessibility to General Practitioner Centres 25
4.2.3 Accessibility to Hospitals 27
4.2.4 Accessibility to Hospitals & GP centres 29

5 CONCLUSIONS AND RECOMMENDATIONS

5.1 CONCLUSIONS 30

REFRENCES 31
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LIST OF TABLES
Caption Page No.

Table 3.1 Data collection sources and their format 14

Table 4.1 Statics of accessibility to maternal and child care centres 22
Table 4.2 Statics of travel time and distance to visit GP centres 23
Table 4.3 Statics of travel time to nearest hospitals 25
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LIST OF FIGURES
Caption Page No.

Figure 1.1 Map showing land use pattern of city of Geelong 3

Figure 2.2 Different aspect of accessibility 7
Figure 3.1 Mesh Block layout for Geelong area 13
Figure 3.2 Process of data collection 14
Figure 3.3 Process of analysis 16
Figure 3.4 Subject area of study 17
Figure 3.5 Road network of City of Geelong 18
Figure 3.6 Population density distribution in Geelong area 20
Figure 4.1 Categorisation of level of accessibility to maternal
and child care centres 22
Figure 4.2 Categorisation of level of accessibility to GP Centres 24
Figure 4.3 Map showing level of accessibility to hospitals 26
Figure 4.4 Map showing ranking of accessibility to health
care facilities in different region of Geelong 27
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LIST OF ABBREVIATIONS

MB Mesh Block
ABS Australia Bureau of Statics
ASGS Australian Statistical Geography Standard
GP General Practitioner
GIS Geographic Information System
ESRI Environmental System Research Institute
GDA Geocentric Datumn Australia
MGA Map Grid Australia
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Chapter 1
INTRODUCTION

1.1 BACKGROUND

Health care service is a basic right of any citizen of a country. It is a government

responsibility to ensure general public have access to high quality health care services
within in reasonable time whenever they need it. Geographically distributed population
and health care facilities and complex transport infrastructure make accessibility to health
services varying depending on the location of patient and health care services provider.
This leads to create some disadvantage areas and under privileged communities with poor
accessibility to health care services. This has been a challenge for town planners, policy
makers and infrastructure engineers since the development of civilization in the world.
Health care facilities have to be positioned so high spatial accessibility is provided for
population.

There are different concepts of accessibility to health care services and various approaches
to measure it. Facilitating access is concerned with helping residents to command
appropriate health care resources to preserve or improve their health. Access is a complex
concept and at least four aspects require for assessment. If services are available and there
is an adequate supply of health care services, then the opportunity to obtain health care
services exists, and a population may have access to services. The extent to which a
population gains access also depends on financial situation, organisational and social or
cultural barriers that limit the utilisation of services. Thus access measured in terms of
utilisation is dependent on the affordability, physical accessibility and acceptability of
services and not merely adequacy of supply. Services available must be relevant and
effective if the population is to gain access to satisfactory health outcomes. The availability
of services, and barriers to access, have to be considered in the context of the differing
perspectives, health needs and material and cultural settings of diverse groups in society.
Equity of access may be measured in terms of the availability, utilisation or outcomes of
services. Both horizontal and vertical dimensions of equity require consideration.
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(The Royal Society of Medicine Press Ltd 2002) however, this study consider only
the spatial accessibility to health care services due to lack of access to the relevant data of
other form of dependent parameters.
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Accessibility based on time taken to get to the service, distance to health services provider
on a specific route (Ingram 1971; Gugliardo 2004) are some of past approaches to measure
accessibility.

Internet research and literature review was conducted and could not found any research
done in this topic in Geelong area.

In order to get the actual picture of accessibility of the area and to make results finer,
smallest possible identified spatial block were used in this study. That is Mesh Block (MB)
introduced by Australia Bureau of Statistics Bureau (ABS). Mesh Blocks are the smallest
geographic region in the Australian Statistical Geography Standard (ASGS), and the
smallest geographical unit for which Census data are available. In 2011, there are
approximately 347,000 Mesh Blocks covering the whole of Australia without gaps or
overlaps. They broadly identify land use such as residential, commercial, agricultural and
parks etc. Mesh Blocks are identified with a unique 11 digit code. (Australian Bureau of
Statistics Website)

In this study health care service provider means General practitioners, Maternal and child
care centre and hospitals where face to face health care service is provided. Resident
means the people who were counted based on MB counts done in census 2011. Road
network used in this study includes only gazetted and recognised roads in Geelong area.
Geographic Information System (GIS) and ArcGIS 10.2 software are to be used for
analysis of data and finding results.

1.2 STUDY AREA

Study area is City of Geelong which is situated 75 km away south west of Melbourne in
Victoria Australia. This study area was selected as it is bit far away isolated from
Melbourne and there are past records which shows the general public in Geelong didn not
get access to health care facilities to the satisfactory level specially with regards to General
Practitioners services (GP).

1.2.1 Population size and growth

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Study area for this research is Geelong area of Victoria Australia which has population of
179,689 as per 2011 census data and estimated to grow upto 235000 by 2016. Geelong
situated in south west of Melbourne lining Corio Bay. Geelong population spreads across
980 km2 area along the coastal line. Due to the stripy nature of the population distribution
geographically, it is more important to study their access to the health care facilities.

1.2.2 Land use

Figure 1.1 shows land use pattern of Geelong area, 75% of land is used for agricultural
purposes. Therefore population density is very low in large part of area.

Figure 1.1 Map showing land use of City of Geelong area

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1.3 HEALTH SYSTEM

A number of developments globally and locally have shifted the way governments and
health agencies are seeking to influence health. Australia has one of the best health systems
in the world. However the system is under pressure from a rapidly growing and ageing
population and the increasing prevalence of preventable chronic diseases. This has shifted
the focus of health planning from service delivery to prevention. In effect, planning has
become focused on addressing behaviours that are linked to increasing levels of lifestyle-
related chronic disease, such as nutrition and insufficient physical activity.

Geelong male residents enjoy 79 years of life expectancy while that of female is 83 years.
Higher hospital admission rates are for dental conditions, pyelonephritis, iron deficiency
anaemia, ear nose and throat infections, and dehydration and gastroenteritis. Nearly 80,000
hospital admissions happen per a year in Geelong.

1.4 PROBLEM STATEMENT

Nature of population distribution spatially in Geelong (stripy form of population

distribution along the coast line) itself create an issue of accessing to health care services
which are concentrated in the city centre. Statistical data also indicates excessive time
taken to get to right medical service.

This study is aim to identify characteristic of accessibility to healthcare services by

spatially distributed population and categorise civilized area into region of low, medium
and high accessibility area.

1.5 RESEARCH OBJECTIVES

Aim of this study is to characterise the spatial accessibility to health care services of
Geelong Area in Victoria Australia based on GIS approach.
Categorise spatial variation of accessibility to health care facilities in terms of
spatial distribution of population, health care service provider and transportation
system.
Identify communities with poor accessibility to health care facilities
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Methodology adopted to study this accessibility is based on GIS base spatial data analysis
and manipulation. Building spatial data bases with relevant data sets covering Geelong
area includes identification of required data sets, research on possible ways to get these
data followed by collection of data. Major steps of this data collection includes creation of
Geodatabase, preparation of required attributes and importation attribute data (from excel)
to ArcGIS format. Conversion of non ESRI data (MapInfo) in to ESRI formats. GIS based
spatial analysis includes identifying spatial pattern of the population distribution, health
care service distribution, road network behaviour and measuring distance and travel time
taken to get to health service provider via road network and identify characteristic of
accessibility to health services.

1.6 SIGNIFICANCE OF THE STUDY

Outcome of this study will identify which area has higher accessibility to paramount
impotent health care service and which area has poor level of access to health services.
That information would be very useful for policy maker and town planer to determine
which area needs more finding hospital and health sector infrastructure improvements. Vic
roads (transport authority of Victoria) may use this to plan their future infrastructure
improvements. Insurance industry can utilise this information to make decision of cost of
health care insurance as people in area of poor accessibility health care facilities more
prone to get severe illness condition because of not having right medical treatment at right
time. On top of all, when purchasing houses, resident can decide which area is more
suitable in terms of health care services.
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Chapter 2
LITERATURE REVIEW

2.1 INTRODUCTION

The aim of this chapter is to review the literature in order to get idea of what other relevant
researches have been done in past and what methodologies they adopted to come to
decision. In the literatures, many approaches have been used to define and measure the key
concepts of access, accessibility and spatial accessibility (i.e. Cameron, 1995; Ansari,
2007). The terms access, accessibility and spatial accessibility are related but very different
concepts (Khan 1992; Cameron 1995) even though in the health care literature these terms
are often used interchangeably. The following sections attempt to clarify the key terms
access, accessibility and spatial accessibility within the context of the work that is
presented in this study.

2.2 ACCESS

Access can be explained as the degree of fit between users and a service. The degree of
fit might be influenced by the availability, accessibility, accommodation, affordability and
acceptability of a service (Penchansky and Thomas, 1981). Furthermore, access is linked
with the demographic, socio-economic and cultural characteristics of the population,
locations of the health care facilities and of the transportation network. In other words,
access is patterned both spatially and socially (Field et al 2004). Spatially, the more
resources that are provided into an area for use the greater the likelihood that people will
use those resources and live in that surroundings. Access to an existing resource or facility
(e.g. a hospital or a road network) is generally understood as the capacity of an individual
to obtain a service when it is needed (Schneider & Symons, 1971). The meaning of access,
however, can vary among researchers, policy makers, politicians and public, due to
differences in their education history, workplace condition, and cultural context.

Over the last four decades, scholars focusing on access issue generally agree that access
is not a well-defined term (Aday and Andersen 1974, Penchansky and Thomas 1981). The
literature also suggests the term access cannot be understood on its own but rather, it
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must be differentiated from other closely related terms, which are often used
interchangeably with the term access, including accessibility, availability, affordably,
barrier, right of entry, right to use, mobility, and level of permission (Bagheri, Benwell et
al., 2005; Guagliardo et al., 2004). Penchansky and Thomas (1981) distinguished two
aspects of access, spatial and socio-economic, and described the spatial aspect of access in
terms of availability, accessibility and accommodation and the socio-economic aspect of
access in terms of affordability and acceptability (Figure 2-1). Bagheri, Benwell et al.,
(2005) and Guagliardo et al., (2004) only consider the first two dimensions as the spatial
components for spatial accessibility. Khan (2002) described access in terms of both spatial
(geographic) and aspatial qualities. In the literature, other terms such as resource
allocation, equity, and social justice are also frequently used by social scientists and
planners. These terms help the planners and policy makers to decide for whom the benefits
are to be distributed, or who gets what and who pays (Talen, 1998). To add to the
complexity of the concept of access, the terms access and accessibility are often used
indiscriminately and are often misunderstood, poorly defined and poorly measured.

Affordability

Acceptability

Spatial Accessibility

Accessibility
Availability

Relevance

Possibility Stay (Accommodation)

Figure 2.2 Different aspect of accessibility

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2.3 SPATIAL ACCESSIBILITY

In a general sense, the term access refers to an entrance into, the right of entry to, or the
use of facilities, and the term spatial accessibility refers to the physical accessibility one
possesses to a preferred location, or the ease at which individuals in one location can reach
another location (Pirie, 1980; Kwan and Weber, 2003). Spatial accessibility refers to the
relationship between the locations of the supply of and the locations of demand for specific
services, taking into account existing transportation infrastructure and travel impedance. In
the literature, spatial accessibility (Freeman, 1986; Oppong and Hodgson 1994; Hewko,
2001; Guagliardo, 2004) and geographical accessibility (McLafferty, 1982; Pooler, 1987;
Brabyn and
Skelly, 2002; Apparicio et al., 2008) are often used in an interchangeable manner, in the
sense that both concepts are location-based and spatially constrained, as Khan (1992) has
noted that spatial accessibility is specifically conditioned by the spatial or distance variable
(as a barrier or a facilitator of access) and the pattern generated has 13 the most direct
geographic manifestation. Some scholars declare that they used the term spatial
accessibility because they want to gain the favour and supported by the literature
published in health care geography category (Khan and Bhardwaj 1994; Luo and Wang
2003; Luo, Wang et al., 2004 and Guagliardo, 2004). The spatial accessibility has been
studied and developed mainly in Geography, Mathematics and Social science but not
limited to physics, planning, public health, transportation, civil engineering etc. Spatial
accessibility is a critical consideration in the provision of both public and private services
(Murray 2003).

2.4 INDICATORS / MEASURES OF SPATIAL ACCESSIBILITY

Walizer and Wienier (1978) define indicator as a class, set or group of potentially
observable phenomena that represents a conceptual definition. Indicators and measures of
accessibility are important for any assessment of health care provision. There have been
several attempts to develop indicators to measure and evaluate accessibility to health care
services. In many situations, information used in indicator of accessibility to health care
services overlaps with information used in other social, economic and planning indicators.
Indicators consist of information which can be used to construct an index. For example, the
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Index of Multiple Deprivation 2000, commonly known as IMD2000, was developed by the
British government, based on six categories of deprivation or domains (Index), to
determine which small areas are having poor geographical access and hence are eligible for
more funding (Niggebrugge et al., 2005). The domains of the index include resident
income, employment, health and disability, education skills and training, housing, and
geographical access to services (IMD, 2000). The geographical access in IMD2000 was
measured as straight line distance between the location of the population and some selected
services. IMD2000 was used to identify poor accessibility clusters and isolated areas where
29% (n=14.4million) of the population of England were located (DETR, 2000).

Indicators of accessibility can be opportunity based (Wachs and Kumagai, 1973).

pportunities to access to a health care service can be specified in terms of a fixed threshold
of travel istance or travel time (Vickerman, 1974; Ben-Akiva and Lerman, 1979). Here
travel time includes notions of friction, barriers, connectivity and critical distance (Crews-
Meyer, 2000). Euclidean distance (Noor et al, 2006; Crawford, 2006; Pang and Lee 2008;
Liu, 2008; Apparicio et al, 2008) and network distance (Apparicio et al, 2003; Sharkey and
Horel 2008) are often used to measure the distances between the health care service
providers and users. Distance is related to access and utilization. The farther the travelling
distance to a service facility, the less likely an individual will use the service facility
(Sherman et al, 2005). Distance can be measured from different locations of importance to
individuals, for example, from the home or orkplace. Some studies have found a greater
propensity for individuals to utilize health services near a place of employment rather than
their residence (Gesler and Meade 1988; Fortney, Rost et al. 2000). Niggebrugge et al
(2005) mentioned two additional indicators of accessibility as calculated using GIS: road
length in measured in kilometres per thousand populations, and the presence of amajor
road in each local community, both were found to have enhanced the power of the
IMD2000 index. Some researchers have argued that the effect of distance on the use of
health services is affected by the time and cost of travel, compounded by topography and
poor road conditions (Vissandjee Barlow et al., 1997; Toan et al., 2002), and by a shortage
of public transport (Mwaniki Kabiru et al., 2002; Krasovec, 2004). Poor road conditions
were associated with longer travel times to reach health care facilities, whereas better road
conditions were associated with regular visits to a physician (Ramsbottom-Lucier et al,
1996). Therefore, good road conditions can be one accessibility indicator because it assists
human mobility within an area. If there is an improvement of the transportation network,
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then it might be anticipated that there will be a change in the level of access to health care
facilities (Wachs and Kumagai 1973). Having a vehicle and a good road network could be
an advantage over the use of a public transportation system. People with a car can travel to
the nearest health care facilities with a reduced travel time compare to those who do not
have a car and have to rely on public transport. Increased travel distance will increase
travel time which directly or indirectly impacts on travel cost as the user takes the effort to
organize their time to visit a health care service. Penchansky and Thomas (1981) describe
this concept as affordability. Bice, Eichhorn et al. (1972) argues that affordable or
subsidized health services provided through Medicare have played a major role in
increasing access to health care services in Australian (and Victoria). Talen (2001)
examined this concept of health care facilities to education services. She found that the
distribution of travel cost between resident locations (blocks) and schools is equitable on
the basis of the density of resident populations and the socioeconomic status (SES) of
resident populations. Spatial inequities in access to school were substantial and varied by
county and school zone. She argues that these issues are potentially relevant when
considering health care service access (Talen, 2001). Thus, the location where an
individual lives is a sensible health care service accessibility indicator which may
beinfluenced by whether the area is urban, rural or urban fringe area. Indicators like the
ratios of number of health care providers or facilities to population are often used to
evaluate the degree of access to care in a designated catchment area. For example, facility-
user ratios (the number of users per facility),doctor-patient ratios, hospital bed-population
ratios, nurse-patient ratios, among others, can be used (Cervigni et al, 2008). Key
considerations and measures of accessibility are summarized in and the most commonly
used measure of accessibility are listed in Table 2-3, which include: (1) measures based on
the gravity potential model, (2) measures based on travel impedance (distance, travel time
and travel cost), and (3) measures based on number of facilities within specified travel
impedance.

Among other accessibility measures utility based measure is complex because in this
model individuals utility using behaviour e.g. travel behaviour, their decision making
preferences e.g. individuals time or ability and satisfaction are used. Space time
accessibility measures is utility based accessibility measure and it have received much
attention in recent years due to their sensitivity to differences in individual ability to
participate in activities in space and time (Miller 1991, Kwan 1998; Weber and Kwan
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2003),. Space-time accessibility measures are based on the construct of the space-time
prism proposed by Hgerstrand (1970) which able be visualized individuals activities and
travel in 3D space-time. On the other hand, the two-step floating catchment area (2SFCA)
method is inspired by the spatial decomposition idea or special type of gravity model was
first proposed by Radke and Mu (2000) to assess social programs. Luo and Qi (2009)
improved the model for measuring spatial accessibility addressing the problem of uniform
access within the catchment by applying weights to different travel time zones to account
for distance decay. This model does not have a distance friction function it relies on a
predefined travel threshold (Wang, 2011) even though it
becomes widely accepted.
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Chapter 3
RESEARCH METHODOLOGY

3.1 INTRODUCTION

This chapter describes the GIS-based research methodology developed for characterizing
spatial variation in access to health care facilities in terms of the spatial distributions of
potential users, health care facilities, and transportation infrastructure, and for identifying
local communities where spatial accessibility to health care facilities is relatively poor.
The Chapter begins with some clarification of key concepts and definition of relevant
terms used in this thesis, and then followed by sections on the following issues:
considerations for selecting the case study area; data requirements of the study, data
collection and preparation; the development and application of geo-processing and spatial
analytical procedures; and the steps involved in the generation, evaluation and refinement
of the outputs (e.g. maps, tables, charts).

3.2 RESEARCH DESIGN

Accessibility to health care facilities has three mentions, temporal, spatial and thematic.
Temporal accessibility means interaction between the time that health institutions are
opened and incidents that patients seek medical services. Spatial accessibility means access
to the health care facilities spatially and thematic component of accessibility means
accessibility in terms of peoples economic, religious and other demographic
characteristics.

Spatial accessibility is conceptualized in this study as the easiness for reaching a

destination location (e.g. location of health care facilities) from a Mesh Block (MB)
centroid by a member of the local community who is driving a car, and measured as the
travel distance or travel time to the nearest health care facility via road network.
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3.4 RESEARCH STRATEGY AND TECHNIQUES

In this GIS analysis mainly ArcGIS 10.2 is used as a tool to analyse road system and
residential area of the subject area. Most of the data were downloaded from reliable
government websites.

Due to the lack of data on users, travel behaviour and users preference to health care
facilities in terms of professionals, facilities, costs, gender or culture, this study assumed
that the residents will travel to their respective nearest health care facilities on road
network, according to the first law of geography, and assumes that all facilities are equal in
terms of users preference. Every van affords to any facilities for the services and all health
care facilities have abilities treat diseases equally.

3.5 CREATING DATABASE

For this study, three data sets are required, road network, Health care facilities and
characteristic of distribution of population in Geelong area. https://data.gov.au/ provides
me the road network of Geelong area. Australian Bureau of Statistics made departments
Mesh Block distribution freely available over internet. The study developed a method to
disaggregate the census data into a finer spatial resolution, i.e. the Mesh Block (MB) level.
MBs are the smallest geographic regions in Australian Statistical Geography Standard
(ASGS) (Australian Bureau of Statistics, 1995). Health care service centre were found in
Yellow Pages and other websites relating to health services (http://www.dhs.vic.gov.au).
Australia continent has been divided into zones called Map Grip Australia as shown in
Figure 3.1 (MGA Zones). all spatial data were in the GDA 94 MGA zone 55 coordinated
systems therefore coordinate system transformation was not needed.

3.5.1 Collection and organization of data

Datasets were downloaded after thorough internet research. Most of the data were taken
from government web sites so data is reliable and it further cross checked with overlay on
Google earth images. Below table shows data sources used to download the data and their
formats.
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Figure 3.1 Mesh Block Layout for Geelong area

Data Source Data Type Description Data Format

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Spatial Road Network City Polygon

https://data.gov.a of Geelong (in form
u/, of segments)
Department of
the Prime Minister Attribute Segment no, Speed
and Cabinet
limits, Road Names,

Spatial Mesh Block Polygon

ABS Boundary
Attribute MB reference no
Spatial Location of Health Points
DHS care service centres
Attribute

Table 3.1 Data collection sources and their formats

Below figure show the procedure followed to get data into database. All the datasets were
downloaded as Zip files and then they were unzipped and loaded to the Geo-databases in
ArcGIS 10.2.

Download Unzip Import

Figure 3.2 Process of data collection

Data about the transportation framework system was gathered from the government Data
Service (https://data.gov.au/). Every one of the streets inside 10 kilometres of the
Subject area was incorporated to get a comprehensive idea of the area. Based on Vicroads
road speed limits, travel time was calculated considering the length of the street segments.
A Network dataset was then created to quantify the travel time and travel distance between
the Health care facilities and the area of the nearby occupants (e.g. MB centroid).

In this study, closeness to health care facilities measured in two different ways, in terms of
travel time and shortest distance as these both parameters together can give a sensible
answer for the research problem. In some cases the route with shortest distance is not the
quickest route. ArcGIS network analysis tool provides facilities to measure this parameter
and plot them spatially. Speed limits (40, 50, 60,70,80,90,100 km/h) were available in the
 16

roads dataset and is utilised for time calculations. In road network dataset creation, it is
assumed all vehicles can stop at any point, can make U turn at any junction and no traffic
lights are considered. In reality this is not true hence travel time would be higher than the
results of this study. It is also assumed that all the vehicles carrying patients travel at
exactly nominated speed which Data
is also not practically happen.
Collection

3.5.2 Material and Equipment Used

Check Data for
Suitability use
Laptop and internet facilities were mainly used for this study.

3.5.3 Software Used

Google earth was used to visualized Geelong urban area, ArcGIS 10.2 and excel are
Geo-Database
mainly used for analysis purposes.

Calculate Attributes Prepared feature

as required class and get them
ready to use status

Health care Road Mesh Block

Centre Segment Feature class
Feature class Feature
class

Road Road
Feature
Network Network
Class of
Quickest Shortest
Route Distance Centroids of
MB

Analysis
Analysis
Analysis
Analysis

Shortest Closest
Travel Distanc
Time e
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Figure 3.3 process of analysis

3.5.4 Population Identification
Geelong urban area of Victoria State is taken as subject area for this study. Geelong is an
area of 75km of south west to Melbourne and it is bit isolated area from Melbourne as
there is a 25Km of farming area in between Geelong and Melbourne.
Many people who lived inside the subject area and work outside of the Geelong area. This
people may tent to go for better facilities outside of the subject area. But there is no data
available to incorporate this information into this study.

Victoria State
Australia

Geelong in Victoria

City of Geelong
 18

Figure 3.4 Subject area of study

3.5.5 Road network

Road network dataset of Geelong area was available in https://data.gov.au/ and

shown in Figure 3.6. Actual speed limits were also available in the road network dataset
and were used for the study to calculate travel time. Although there are bus and train
facilities in Geelong area, it is really unlikely a patient travels to health care facilities in a
bus or train in Australia. Therefore in this study it is assumed that no patient will used
either train or bus to get to health care service centre. It means all the patients use own car,
ambulance service or taxi to get to health care facilities. It is also assume that people drive
their vehicles at 60km/h in 60 Zone although then can dive at various speeds between 50-
66 km/hr.
 19

Figure
3.5 Road network in City of Geelong

3.6 ANALYSIS OF ROAD NETWORK

All the required data was collected and imported into Geodatabase and number of
analytical procedures was implemented to get the required answer for question mentioned
in the section 1.4 of this report.

3.6.1 Mapping of health care facilities, population distribution and road system
 20

Population density map shown in figure 3.6 was created using data available from
Australian Bureau of Statistics. Calculate Geometry tool was used to calculate area of
Mesh block and then population densities were calculated. Road network were mapped to
show different speed zones.

3.6.2 Create network datasets

New networks datasets were created within the Geo-database for the analysis purposes. U
turn restriction was not set up for simplicity and lack of data. Connectivity of the road
networked data was very poor initially. In order to connected line features at junctions
Integrate tool in ArcGIS was used, tolerance of 20m was given and that was enough to
connect the whole road network together.

Two set of network datasets were created for analysis in terms of shortest distance and
quickest time to get to Health care facilities.

3.6.3 Analysis of road network

Analysis was conducted to identify different zones of accessibility to health care facilities.
4, 8 and more than 8 minutes were the breaking points for the analysis when zoning in
terms of time.
 21

Figure 3.6 Population Density distributions in Geelong Area

 22

Chapter 4
RESULTS AND DISCUSSION

4.1 INTRODUCTION

This chapter describes results and importance of findings of the study. Analysis results are
presented for three subjected health facilities which are Maternity care centres, General
Practitioner Centres and hospitals. Overlay analysis were conducted to identify
disadvantage areas. Hospital and GP centre were considered as most significant health care
facilities as an average family visits GP centre a 8 times a year and being closer to a
hospital wound benefit at any time for a family because of emergency health care needs.
Therefore analysis was extended by combining results of accessibility to GP centres and
hospitals so Accessibility Ranking system can be identified for different areas in the city of
Geelong.

It should be noted that for this travel time calculations, time delays due to colour lights,
disturbances from other road users, give way to other road users, parking times have not
been accounted. It is assumed that people are travelling at exactly nominated speed limits,
for example if it is 60km/hr zone, people travel at 60km/hr but practically in most cases
people drive little below the speed limit like 55-58km/hr Therefore actual travelling times
are always higher than travelling times found in this study. However for identifying
geographic areas in terms of level of accessibility to health care services these values are
reasonable.

4.2 ACCESSIBILITY TO HEALTH CARE FACILITIES

Accessibility health care facilities were analysed in terms of shortest travel time from
centroids of Mesh Blocks (Census departments smallest division of area within a suburbs).
Break points were 4,8 and more than 8 minutes for identifying accessibility level of high,
medium and low respectively.
 23

4.2.1 Accessibility maternal and child care centres

Maternity centre services are required for any family during the pregnancy of women and
after delivery. Being closer to Maternity and child centres can be considered as a luxury. In
Geelong city 22 Maternity and child care centres are there covering whole city.
Accessibility can be presented as shown in the figure 4.1. All densely populated area have
high level of accessibility (Maternal care Centre with 4 minutes of travel) while low
population area have low level of accessibility when it moves away from city centre. In
table 4.1 show statics of travelling to get to a maternity/Child care centre, it is found that
some people can get to Maternity care centre by walking while people live in remote area
have to 38km to see a maternity nurse or get immunisation for babies. Average family have
to travel 2.8km that means it is not walking distance therefore car or taxi has to be used as
public transport in Geelong area is not so frequently available.

Time (Minutes) taken to Distance (Km) travelled to

travel to maternal Care get to Maternity Care Centre
Centre
 24

Average 1.59 2.835

Maximum 20 38.175
Minimum 0.009 0.003
Standard Deviation 1.3 3.988

Table 4.1 Statistics of accessibility to Maternity/Child Care Centres

 25

Figure 4.1 Categorisation of Level of accessibility maternal care centres

 26

4.2.2 Accessibility General Practitioner Centres

Average family visits general practitioner 8 times a year that means most frequently visited
health care service of a community. In Geelong area 14 GP centres have been identified
and located geographically.

Time (Minutes) taken to Distance (Km) travelled to

travel to maternity Care get to Maternity Care Centre
Centre
Average 2.54 2.935

Maximum 19.2 37.175

Minimum 0.01 0.004
Standard Deviation 2.5 4.288

Table 4.2 Statics of travel time and distance to visit a GP Centre

Total population in Geelong subject area as per census 2011 is 202,242. As per statistics in
Table 4.2 all the people have access to a GP centre spatially within 20 minutes. Average
person travel can see a general practitioner less than 3 minutes of travelling time. People
live in outer boundary of the Geelong area needs generally 20 minutes to get to the nearest
GP centre.

Figure 4.2 shows the how level of accessibility to GP centres varies throughout the
Geelong region. People live in urban areas such as Sough Geelong, Highton, Thomson,
Belmont, Newton suburbs have high level of accessibility and while families in suburbs
such as Anakie, Balliang, Little River, Maude have to travel far more to get to see a doctor.
It should be noted that this study discuss only spatial accessibility to health care facilities.
 27

Figure 4.2 Categorisation of level of accessibility to GP Centre locations

 28

4.2.3 Accessibility Hospitals

All the people need to access to hospital in the life time. In case of emergencies, it is very
vital to get into a hospital as quickly as possible. There are six hospitals in City of Geelong
area for population of 202,242. Table 4.3 shows statics of travel time to go to nearest
hospital in Geelong. Further Figure 4.3 shows variation of accessibility throughout the
Geelong region.

Time (Minutes) taken to Distance (Km) travelled to

travel to maternity Care get to Maternity Care Centre
Centre
Average 2.54 3.35

Maximum 19.2 40.175

Minimum 0.01 0.005
Standard Deviation 2.5 4.988

Table 4.3 Statistics of times to travel to a nearest hospital

 29

Figure 4.3 Map showing levels of accessibility to hospital in City of Geelong

 30

4.2.4 Accessibility Hospitals and GP Centres

For any average family, most important health care services are access to see a General
Practitioner and hospitalisation. Therefore when accessibility of these two facilities are
combined together, entire Geelong area can be ranked as shown below Figure 4.5.

Figure 4.4 Map showing ranking of accessibility to health care facilities in different region of Geelong
 31

Chapter 5
CONCLUSIONS AND RECOMMENDATIONS

5.1 Conclusion

This study reveals that on average 2.54, 2.835 and 3.35 minutes are taken to reach nearest
Maternal and child care centre, GP Centre and hospital respectively. However people live
in top north part of the city have very low access to health care facilities in general while
all the health care facilities are concentrated in to middle part of the City the reason for that
is population density is very high in the area. All surrounding areas are agricultural zones
with very low population densities. Improving road infrastructure so higher speed limits
can be establish will certainly reduce the time to reach GP centres and hospitals.
 32

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