Identification of areas with geographic difficulties in accessing public health services in Costa Rica: a methodological proposal

Aim: The purpose of this study is to present and apply a methodological tool to identify areas in which access to health services could be difficult for the population due to geographical barriers, both in terms of distance to the medical center and travel capacity, specifically in the cantons of Curridabat, Escazú, and Desamparados.

Methods: based on the geographic division of the country in minimum geostatistical units carried out by the National Institute of Statistics and Census, the distance in minutes was calculated for each unit that it would take to walk, by the fastest real route, from the minimum geostatistical unit to the headquarters of its assigned basic health care team.

Results: 3.4% of the population studied lived in a minimum geostatistical unit classified as having significant difficulty in accessing health services, as it had both the physical barrier of distance and low mobility by automobile and low socioeconomic status. Sixty-five minimum geostatistical units were identified (out of 2014 included in the study) that were more than a 20-minute walk from the headquarters of their basic health care team and whose population had low travel capacity and low socioeconomic status; most of them were in the Desamparados Health Area.

Conclusion: This study presents a methodological tool to be applied in the identification of areas whose population may find it difficult to access health services geographically, both because of their distance to a medical center and their ability to travel, specifically in the cantons of Curridabat, Escazú, and Desamparados.