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

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.