@article{fdi:010071911,
  title = {{D}oes the edge effect impact on the measure of spatial accessibility to healthcare providers ?},
  author = {{G}ao, {F}. and {K}ihal, {W}. and {L}e {M}eur, {N}. and {S}ouris, {M}arc and {D}eguen, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {S}patial accessibility indices are increasingly applied when investigating inequalities in health. {A}lthough most studies are making mentions of potential errors caused by the edge effect, many acknowledge having neglected to consider this concern by establishing spatial analyses within a finite region, settling for hypothesizing that accessibility to facilities will be under-reported. {O}ur study seeks to assess the effect of edge on the accuracy of defining healthcare provider access by comparing healthcare provider accessibility accounting or not for the edge effect, in a real-world application. {M}ethods: {T}his study was carried out in the department of {N}ord, {F}rance. {T}he statistical unit we use is the {F}rench census block known as '{IRIS}' ({I}lot {R}egroupe pour l'{I}nformation {S}tatistique), defined by the {N}ational {I}nstitute of {S}tatistics and {E}conomic {S}tudies. {T}he geographical accessibility indicator used is the "{I}ndex of {S}patial {A}ccessibility" ({ISA}), based on the {E}2{SFCA} algorithm. {W}e calculated {ISA} for the pregnant women population by selecting three types of healthcare providers: general practitioners, gynecologists and midwives. {W}e compared {ISA} variation when accounting or not edge effect in urban and rural zones. {T}he {GIS} method was then employed to determine global and local autocor-relation. {L}astly, we compared the relationship between socioeconomic distress index and {ISA}, when accounting or not for the edge effect, to fully evaluate its impact. {R}esults: {T}he results revealed that on average {ISA} when offer and demand beyond the boundary were included is slightly below {ISA} when not accounting for the edge effect, and we found that the {IRIS} value was more likely to deteriorate than improve. {M}oreover, edge effect impact can vary widely by health provider type. {T}here is greater variability within the rural {IRIS} group than within the urban {IRIS} group. {W}e found a positive correlation between socioeconomic distress variables and composite {ISA}. {S}patial analysis results (such as {M}oran's spatial autocorrelation index and local indicators of spatial autocorrelation) are not really impacted. {C}onclusion: {O}ur research has revealed minor accessibility variation when edge effect has been considered in a {F}rench context. {N}o general statement can be set up because intensity of impact varies according to healthcare provider type, territorial organization and methodology used to measure the accessibility to healthcare. {A}dditional researches are required in order to distinguish what findings are specific to a territory and others common to different countries. {I}t constitute a promising direction to determine more precisely healthcare shortage areas and then to fight against social health inequalities.},
  keywords = {{E}dge effect ; {P}otential spatial accessibility of healthcare professionals ; {E}2{SFCA} algorithm ; {G}eographic information systems ; {S}patial analyses ; {P}regnant women ; {FRANCE}},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {H}ealth {G}eographics},
  volume = {16},
  numero = {},
  pages = {46 [16 ]},
  ISSN = {1476-072{X}},
  year = {2017},
  DOI = {10.1186/s12942-017-0119-3},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071911},
}