Addressing inequalities in access to healthcare in France: combined perspectives of management and health geography

Territorial inequalities in access to care and the lack of health practitioners represent one of the important challenges health systems are facing worldwide. Territorial management seems to be the discipline to address these concerns in a holistic and interdisciplinary way, specifically via the concept of lived territory. Territorial management and health geography share the same vision on the definition of the lived territory, namely a territory which is a social construction, dynamic and shaped by its users. However, territorial management lacks tools to define the lived territory, whereas the ‘relative flows’ method in health geography identifies users’ real healthcare consumption on the territory, offering an operational tool for stakeholders, including healthcare professionals and local decision makers. Focusing on the intersection of management and health geography, this study is looking to address the question: to what extent would the inter- and transdisciplinary approach enable an effective response to the difficulties of access to care in the territory? This research is based on a case study of the French region Centre-Val de Loire. The findings of the study emphasise an added value of the inter- and transdisciplinary approach in operationalisation of territorial management discipline. The lived territory concept appears a most appropriate grid in the evaluation of inequalities in access to care and thus an effective tool to mobilise the involvement of healthcare stakeholders in a new territorial organisation centred on user needs in care.