<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022022000200004</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Identificación de las zonas con dificultades geográficas de acceso a los servicios públicos de salud en Costa Rica: una propuesta metodológica]]></article-title>
<article-title xml:lang="en"><![CDATA[Identification of areas with geographical access difficulties to public health services in Costa Rica: a methodological proposal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fantin]]></surname>
<given-names><![CDATA[Romain]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Duarte]]></surname>
<given-names><![CDATA[Ingrid]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rojas-Araya]]></surname>
<given-names><![CDATA[Karol]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sáenz-Bonilla]]></surname>
<given-names><![CDATA[Juan Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barboza-Solís]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Medicina Escuela de Salud Pública]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Medicina Escuela de Salud Pública]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Medicina Escuela de Salud Pública]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Medicina Escuela de Salud Pública]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Odontología ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>64</volume>
<numero>2</numero>
<fpage>4</fpage>
<lpage>15</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022022000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022022000200004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022022000200004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  el propósito de este estudio es presentar y aplicar una herramienta metodológica para identificar las zonas en las cuales el acceso a los servicios de salud pudiera resultar difícil para la población debido a la barrera geográfica, tanto por su distancia al centro médico, como por su capacidad de desplazamiento, específicamente en los cantones de Curridabat, Escazú y Desamparados.  Métodos:  a partir de la división geográfica del país en unidades geoestadísticas mínimas realizada por el Instituto Nacional de Estadísticas y Censos, se calculó, por cada unidad, la distancia en minutos que se tardaría en recorrer caminando, por la ruta real más rápida, desde la unidad geoestadística mínima hasta la sede de su equipo básico de atención en salud asignado.  Resultados:  el 3,4% de la población estudiada vivía en una unidad geoestadística mínima clasificada como con dificultad importante de acceso a los servicios de salud, pues presentaba tanto la barrera física de la distancia, como poco desplazamiento en automotores y baja condición socioeconómica. Se identificaron 65 unidades geoestadísticas mínimas (sobre 2014 incluidas en el estudio) que se encontraban a más de 20 minutos caminando de la sede de su equipo básico de atención en salud y cuya población contaba con baja capacidad de desplazamiento y baja condición socioeconómica; la mayoría de ellas en el Área de Salud de Desamparados.  Conclusión:  este estudio presenta una herramienta metodológica para aplicar en la identificación de zonas a cuya población le pudiera resultar difícil el acceso geográfico a los servicios de salud, tanto por su distancia a un centro médico, como por su capacidad de desplazamiento, específicamente en los cantones de Curridabat, Escazú y Desamparados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Aim:  The objective of this study is to present and apply a methodological tool to identify the areas in which the inhabitants could have geographic access difficulties as a barrier to access to health services, both because of its distance from the health center and its mobility capacity, specifically in the cantons of Curridabat, Escazú and Desamparados.  Methods:  Based on the geographical division of the country into minimum geostatistical units carried out by the Instituto Nacional de Estadísticas y Censos, the distance in minutes that it would take to walk it was calculated for each unit, based on the actual fastest route between the minimum geostatistical unit and the headquarters of its assigned basic health care team.  Results:  An 3.4% of the studied population lived in a minimum geostatistical unit classified as having significant difficulty accessing health services since they accumulated both the physical barrier of distance and little mobility in automobiles. 65 minimum geostatistical units were identified (out of 2014 included in the study) as being at more than 20 minutes walking from the basic health care team, with a population with low mobility capacity, and consequently low socioeconomic status. Most of these were found in the Desamparados Health Area.  Conclusion:  This study presents and applies a methodological tool to identify the areas in which the inhabitants could have geographic access difficulties as a barrier to access to health services, both due to their distance from the health center and their mobility capacity, in Curridabat, Escazú and Desamparados.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[accesibilidad a los servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[factores socioeconómicos]]></kwd>
<kwd lng="es"><![CDATA[geografía médica]]></kwd>
<kwd lng="es"><![CDATA[salud pública]]></kwd>
<kwd lng="es"><![CDATA[movilidad]]></kwd>
<kwd lng="es"><![CDATA[primer nivel]]></kwd>
<kwd lng="en"><![CDATA[Health Services Accessibility]]></kwd>
<kwd lng="en"><![CDATA[Socioeconomic Factors]]></kwd>
<kwd lng="en"><![CDATA[Geography Medical]]></kwd>
<kwd lng="en"><![CDATA[Public Health]]></kwd>
<kwd lng="en"><![CDATA[Mobility]]></kwd>
<kwd lng="en"><![CDATA[Primary care]]></kwd>
</kwd-group>
</article-meta>
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