Association Between Spatial Accessibility of Oral Healthcare Services using Geo-Mapping and Oral Healthcare Services Utilization in a Geographic Area of Andhra Pradesh, India

Abstract

Objective: The study aimed to assess the relationship between spatial accessibility of oral healthcare facilities and dental service utilization rates in a geographic area of Andhra Pradesh, India.

Methods: This cross-sectional study was conducted in one urban (administrative wards) and two rural areas in West Godavari district of Coastal Andhra Pradesh, India. All private, public and dental care settings of teaching institutions located within the 20 km radius were plotted using Google’s open street map. Arc GIS Pro software was used for attribute analysis and determining buffer zones. 520 per each area, together 1560 individuals were selected through stratified cluster random sampling to measure annual dental service utilization rates. Chi-square test and Fisher’s exact tests were used for bivariate analysis and binary logistic regression analysis to assess the predictors of dental service utilization.

Results: In this study out of 1560 individual contacted, 1507 agreed to participate. Forty-nine oral healthcare centers were geo-tagged. Availability of dental services within 15 minutes of travel time [odds= 4.64; P=0.000] and located within 6-10 km distance from the patient’s residence [odds= 3.22; P=0.002] were the two significant factors associated with oral healthcare service utilization rates.

Conclusion: There is an uneven distribution of oral healthcare facilities which reflects on the utilization rates. A measure to reduce the urban-rural gap in spatial distribution is essential to enhance the dental service utilization rates.