A spatial analysis of the geographic distribution of musculoskeletal and general practice healthcare clinics in Auckland, New Zealand

Abstract

BACKGROUND & AIMS: Musculoskeletal disorders represent a substantial health burden, both within society and to the general practice workload. Although a number of allied and complementary musculoskeletal healthcare options are available in the primary healthcare system, the geographic distribution of such healthcare clinics may be subject to a number of social and commercial influences that may not take into account the healthcare needs of the population. The dual aims of the study reported in this thesis were to determine the extent to which the geographical distribution of musculoskeletal healthcare clinics varies across urban Auckland, in comparison to general practitioner (GP) clinics, and to determine factors which may be related to variations in the spatial pattern of clinic locations.METHODS: The locations of all physiotherapy, chiropractic, osteopathic, podiatry, acupuncture and GP clinics in urban Auckland were mapped and analysed using a combination of spatial statistical tools. Kernel density, Getis-Ord Gi* and Local Moran’s I statistics were utilised to visualise clinic spatial distributions and patterns. Regression modelling using Ordinary Least Squares and Geographically Weighted Regression statistics was conducted to describe relationships between clinic locations and the urban environment. RESULTS: Musculoskeletal clinics showed evidence of clustering in central and northern parts of Auckland, with regression analyses highlighting the importance of clinic proximity to major roads and urban centres, and location within areas of higher percentages of European residents and socioeconomic prosperity. GP clinics appeared more evenly distributed across the study area, with areas of higher clinic density particularly in central and southern Auckland. CONCLUSION: The results of this study suggest that musculoskeletal clinics may tend to be positioned to capture the commercial advantages of location within urban areas with a high commuter inflow and a population with the financial resources to afford privately funded treatment. These results may help to inform the development of strategies to improve the accessibility of musculoskeletal healthcare services for people living or working in areas with low provision of musculoskeletal clinics.