[Assessment of geographic accessibility in hierarchical health systems using the p-median model: an application in Santa Catarina State, Brazil].

The objective of this study is to compare the distribution of hospital units according to different degrees of specialization in Santa Catarina State, Brazil, based on an application of the p-median hierarchical model in three levels. The p-median model is used to determine the units' location, following by a comparison of the population's mean distance to reach the medical units in two scenarios, the current one and the simulation. A quantitative indicator of accessibility is proposed and used to assess accessibility according to the current and simulated distributions. The study aims to detect underserved regions and provides a tool to aid health managers' decision-making for possible interventions in the system in order to make it more homogeneous and accessible to the population.