Simulated GP clinic closure: effects on patient access in the Irish Mid-West

Area of Science:

• Health Services Research
• Rural Health
• Geographic Information Systems (GIS) in Health

Background:

• Rural communities often experience greater healthcare access barriers due to staff shortages, fewer services, and geographical isolation.
• General Practitioner (GP) services are crucial for primary care in rural areas.

Purpose of the Study:

• To assess the availability of GP practices in rural Ireland's Mid-West region.
• To evaluate the potential impact of GP practice closures on patient access in these areas.

Main Methods:

• Identified GP clinic locations and Small Areas (SAs) in Counties Clare and Limerick, Ireland.
• Classified SAs into six rurality levels using Irish Central Statistics Office classifications.
• Calculated direct linear distances from SAs to closest GP clinics and simulated practice closures to assess changes in access.

Main Results:

• The majority of SAs in Clare (63%) and Limerick (66%) are classified as rural (rurality index ≥4).
• Rural SAs exhibit longer travel distances to GP clinics compared to urban SAs, with distances increasing with higher rurality.
• Simulated GP clinic closures led to stepwise increases in travel distances, particularly in more rural areas (r²=0.31).

Conclusions:

• Rural residents in Ireland's Mid-West face longer travel times to GP services.
• Rural communities are more vulnerable to the adverse effects of GP clinic closures.
• Maintaining primary care in rural areas necessitates strategic service and workforce planning.