Rosero-Bixby, L. (2004). Spatial access to health care in Costa Rica and its equity: a GIS-based study. Social Science & Medicine, 58(7), 1271-1284.

Kevin presented a paper that used GIS analysis to investigate differential access to health care in Costa Rice. The data consisted of census data and health care provision data, with missing data acquired through the use of telephone interviews. The author also conducted random field visits to hospitals and did some groundtruthing for the GPS coordinates.

The author built a model to simulate distance to the nearest healthcare facility, mapping proximity to outpatient facilities. The smallest distances were clustered around San Jose but were otherwise very sparsely distributed. The model also accounted for visitor’s satisfaction and the choices they make when selecting between healthcare facilities.

The results indicated that 12-14% of the population of Costa Rica were underserved. On a temporal scale, inequity declined by up to 30% as a result of reforms in 1995 and 1996, although this number has been steadily increasing in recent years.

Overall, Kevin gave this paper a 9/10 because the models were well designed and the data was carefully validated. However, some decisions (i.e. cut-off values in the models) appeared to be selected arbitrarily.