  Although improving financial access is in the spotlight of the current U.S.
health policy agenda, this alone does not address universal and comprehensive
healthcare. Affordability is one barrier to healthcare, but others such as
availability and accessibility, together defined as spatial accessibility, are
equally important. In this paper, we develop a measurement and modeling
framework that can be used to infer the impact of policy changes on disparities
in spatial accessibility within and across different population groups. The
underlying model for measuring spatial accessibility is optimization-based and
accounts for constraints in the healthcare delivery system. The measurement
method is complemented by statistical modeling and inference on the impact of
various potential contributing factors to disparities in spatial accessibility.
The emphasis of this study is on children's accessibility to primary care
pediatricians, piloted for the state of Georgia. We focus on disparities in
accessibility between and within two populations: children insured by Medicaid
and other children. We find that disparities in spatial accessibility to
pediatric primary care in Georgia are significant, and resistant to many policy
interventions, suggesting the need for major changes to the structure of
Georgia's pediatric healthcare provider network.
