Identification of the Relationships among Geographic Accessibility of Healthcare Resources, the Diagnosis of HCC and Health-Seeking Behaviors of Patients with HCC

Preface: The role of geographic information system is increasingly important in the field of public health. The study tries to use detailed spatial information to identify the relationships among Geographic accessibility of healthcare resources, the diagnosis of HCC and health-seeking behaviors of patients with HCC.
Method: Using "two-step floating catchment area method" to establish the "geographic accessibility of primary care", and "gravity model" to the "geographic accessibility of HCC specific treatment" of townships in Taiwan. Take patients with HCC for example to identify the relationships among geographic accessibility of medical resources, early diagnosis of HCC, cross district health seeking and treatment delay.
Results: The "geographic accessibility of primary care" of townships presents a lot of differences from traditional method. Higher rank of the "geographic accessibility of primary care" of patients with HCC has higher possibility to be patients with early HCC (odds ratio=1, 1.15, 1.14, and 1.27). There is non-linear relationship between the "geographic accessibility of HCC specific treatment" of patients with early HCC and cross-district health seeking behavior (odds ratio=1, 1.84, 0.32, and 0.07). However no relationship found between treatment–delay and spatial barriers of hospital-seek behavior in patients with early HCC.
Conclusion: This study employed GIS-based accessibility approach. We identify the geographic accessibility of medical resources significantly affected the stage diagnosed and hospital-seeking behavior of patients with HCC. Treatment patterns, treatment qualities and outcomes of cancer hospitals need to be considered further to explain cross-district hospital-seeking behavior more comprehensively.