Assessing Population-level Accessibility to Medical College Hospitals in India: A Geospatial Modeling Study

BackgroundWhile studies have investigated the availability of Medical College Hospitals (MCHs) in India, data on geographic accessibility are limited. Our study examines current geographic accessibility to these MCHs across 36 states and union territories and 735 districts. MethodsWe validated MCH data from the National Health Profile 2022, using travel-time rasters from the Malaria Atlas Project (2019) and population data from WorldPop (2020). We examined the density of MCHs per million population and the median travel time to the nearest MCH. We assessed the Access Population Coverage (APC), defined as the proportion of the population within 30, 60, 90, and 120 minutes by motorized transport, and within 30 and 60 minutes by walking, to the nearest MCH. ResultsIn 2022, India had an average density of 0.47 MCHs per million. The median travel time to the nearest MCH was 67.94 minutes by motorized transport and 589.82 minutes by walking. 71.76% of the population could access the nearest MCH within 60 minutes by motorized transport. The APC was 64.20% within 60 minutes by motorized transport in rural areas vs. 92.34% in urban areas. The APC within 60 minutes by motorized transport for public MCHs was 63.62%, while that for private was 45.95%. ConclusionsMedian travel time and APC help assess geographic accessibility. Our study found wide disparities in MCH access across Indian states and rural vs. urban areas. These analyses can guide the optimal placement of new MCHs.