Disparity in community medical care accessibility against acute influenza in Taiwan

As part of a comprehensive preparation plan to defend against fast spread of acute influenza in Taiwan, the present study was conducted to compare the medical care accessibility of residents in 25 communities throughout Taiwan to ensure uniform adequacy of medical care facilities to provide timely treatment for acute influenza outbreaks. Appropriate GIS techniques were used to estimate the portions (%) of residents covered by a medical care facility within three miles of distance from a patient's residence, taking into account the availability of roadways. This level of medical care accessibility (MCA) was found to have a rather wide distribution. In highly developed urban communities such as those in Taipei City, over 90% of residents enjoy the proper MCA, whereas in less developed rural communities such as those in Chiayi County, less than 20% of residents have the same MCA. The rather large disparities in MCA among different yet closely connected communities in relatively crowded areas in Taiwan present a profound negative implication in the effectiveness of preparation against the spreading of a highly virulent strain of influenza. Those with no proper MCA, once infected, will allow the disease and the associated virus to more fully develop. Our results provide for national health authorities with rationalized strategic sites for investment in building additional medical care facilities or relocation of existing facilities to narrow the gaps in MCA for better defense against acute influenza. The methodologies we developed in this study demonstrate the power of combining GIS techniques, roadmap and demographic analyses, and mining on census data in public health research.