Studies have shown that the distribution of health services infrastructure, the ongoing socioeconomic and demographic factors and ethnic gaps act as barriers to healthcare access. To this end, geographical information systems (GISs) and exploratory spatial data analysis (ESDA) have been widely used to visualize spatial patterns in the assessment of access to healthcare, health outcomes and the resulting health disparities. However, much less research have been conducted in examining the actual delivery of care using GIS approaches or understanding the spatial associations between healthcare access, utilization and health outcomes. This research aims at filling this gap. It aims to purport preliminary evidence on the effects of primary care access and utilization on health outcomes in Turkey and their relationship to the geographic environment by conducting a set of spatial analyses for the 2008-2013 period. This research is the first attempt to reveal these spatial associations in Turkey and one of the very few endeavors to assess spatial ties in healthcare within a framework that also accounts for temporal dynamics. Unraveling the spatial spillovers and heterogeneity in utilization and health outcomes is conducive to sound health policies that are designed to prevent health inequalities and ensure an equitable geographic distribution of healthcare resources by identifying regions that suffer from shortages of healthcare infrastructure and health workforce.
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