The tyranny of distance - mapping accessibility to polysomnography services across Australia

Objective: To identify service gaps by mapping accessibility to diagnostic sleep studies across Australia using a Geographic Information System (GIS). Methods: Census-level data stratified by statistical areas were mapped to measure accessibility to polysomnography (PSG) based on geographical location of patients. All adult publicly funded home and laboratory-based PSG performed in Australia in 2012 were mapped to statistical areas based on patient address at the time of the sleep study. Results: Sleep health care is extremely under-resourced in central and northern Australia. For those living in areas classified as remote and very remote, geographical distance appears to be a barrier to the accessibility of specialist sleep services. Conclusions: Remote and very remote communities continue to experience inequity in health care in general and in accessibility to specialist services in particular. Attention needs to be given to barriers which may limit equitable accessibility. Implications: Residing in remote communities with limited or no public transport options is likely to have a particularly significantly impact on Aboriginal and Torres Strait Islander peoples' ability to access PSG.