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Spatial accessibility of home visiting nursing: An exploratory ecological study.

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Area of Science:

  • Gerontology and Health Services Research
  • Spatial Analysis in Healthcare
  • Nursing Policy and Management

Background:

  • Japan faces an aging population and relies on community-based integrated care systems.
  • Home visiting nursing (HVN) is vital for older adults living in their communities.
  • A shortage of home visiting nurses and lack of accessibility indicators pose challenges.

Purpose of the Study:

  • To develop and validate a population-weighted spatial accessibility index (PWSAI) for home visiting nursing (HVN) services.
  • To assess regional disparities in HVN accessibility in Hokkaido, Japan.
  • To provide a standard for resource allocation and inform future nursing policies.

Main Methods:

  • Utilized the two-step floating catchment area (2SFCA) method to estimate PWSAI.
  • Incorporated population, HVN agency locations, nurse numbers, and travel time into the 2SFCA model.
  • Employed a multivariate regression model to validate PWSAI against HVN user numbers and other healthcare resources.

Main Results:

  • The median PWSAI was 9.0 (IQR: 6.2-11.8), revealing significant regional variations.
  • PWSAI was significantly correlated with the number of HVN users.
  • The availability of 24/7 home visiting nurses was a significant factor influencing accessibility.

Conclusions:

  • The developed PWSAI effectively measures the accessibility of home visiting nursing services.
  • The PWSAI can guide resource allocation to address regional disparities in HVN.
  • This indicator supports the development of policies to improve access to care for older adults.