Accessibility to Health Care in Rural Ireland Ms. Karyn Morrissey, University of Leeds, School of Geography & RERC, Teagasc, geokmm@leeds.ac.uk Prof. Graham Clarke, University of Leeds, School of Geography, g.p.clarke@leeds.ac.uk Dr. Dimitris Ballas, University of Sheffield, School of Geography, D.Ballas@Sheffield.ac.uk Dr. Stephen Hynes, Rural Economic Research Centre, Teagasc, Stephen.Hynes@teagasc.ie Dr. Cathal O’Donoghue, Rural Economic Research Centre, Teagasc, C.ODonoghue@teagasc.ie Abstract This paper examines the geographical variations in access to General Practitioner (GP) services for at both the sub-national level using the static components a spatial microsimulation model and spatial interaction models. Data taken from a spatial static microsimulation model is combined with data on the supply of GP services data within a spatial interaction model to provide an indication of flows between residents of the smallest geographical output level, electoral divisions (EDs) and GP services in Co. Galway. Using the output from the spatial interaction model, accessibility indicators are used to estimate accessibility scores for each ED. The second part of the analysis uses a logit model to estimate the probabilities of the residents of each ED using a GP service in the previous year given their individual attributes. Comparing the predicted probabilities of using a GP service at the ED level and the access scores for each ED in relation to GP services highlights areas with poor access to GP services given their demand for health care. 1. Introduction Given that it is health care is one of the only public service that it utilised by everyone throughout their life-time the provision of public health care. Health care services in Ireland are currently experiencing significant difficulties in the delivery of their services. With regard to these difficulties, media reports tend to focus on the problems and issues surrounding acute hospital provision, such as; increased attendances at A&E departments, increased waiting time for A&E treatment and acute inpatient beds and the widespread cancellation of elective procedures. In contrast, the provision of primary (and community care) receives significantly less attention. Primary care providers, in particular GPs, act as gatekeepers to acute care and whilst the annual cost of hospital care greatly exceeds that of primary care, the number of individuals receiving hospital care is only a fraction of the number of people receiving primary care. It is estimated that in Ireland that there are between 15-16 million GP consultations each year, compared to approximately 1.9 million out-patient consultations (DoHC, 2001).