Determining spatial access to opioid use disorder treatment and emergency medical services in New Hampshire

Abstract

This research presents an analysis of spatial access to both opioid use disorder treatment facilities and emergency medical services in New Hampshire during 2015-2016, a period during which there was a steep increase in unintentional overdoses involving fentanyl. For this research, spatial access was computed using the enhanced two-step floating catchment area model combined with the Huff model to assess access across New Hampshire and give attention to supply-side parameters that can impact spatial access. The model is designed to measure access to healthcare services for opioid use disorder patients offered at treatment centers or from buprenorphine treatment practitioners, as well as from emergency medical services across New Hampshire. A composite index of accessibility is proposed to represent overall access to these different treatment services for opioid use disorder patients. Geospatial determinants of spatial access included street network distances, driving times and distance decay relationships, while other key factors were services availability and population demand. Among the towns with the highest composite access scores, approximately 40% were metropolitan locations while 16% were rural towns. The insights from this research showed that for this period, while the opioid crisis was impacting many towns in New Hampshire, high levels of access to treatment services were not uniform across the state. When comparing the access results with data on the towns of residence for individuals who died from unintentional overdoses involving fentanyl during 2015 and 2016, estimates found that approximately 40% of the towns were not estimated to be in the highest class of access to treatment services at the time. This research provides information for local public health officials to support planning strategies to address opioid use disorder treatment access in high-risk regions.

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

“…Data on names and location of OUD treatment and recovery service providers was compiled from multiple sources including online treatment locators [35,36], historical records from the National Directory of Drug and Alcohols Abuse Treatment Programs (NDAATP) [37][38][39][40][41], current resource guides compiled by the Franklin County Alcohol, Drug and Mental Health (ADAMH) Board and local public health departments (e.g., Columbus Public Health, Franklin County Public Health). Other studies have used similar approaches to identify OUD treatment providers for studying access to treatment [42]. In Ohio, local ADAMH Boards certify and license alcohol, drug and mental health providers in each county.…”

A comparison of methods for measuring spatial access to health care

“…To overcome this difficulty, Cao et al merge an E2SFCA approach with a Huff model to measure travel impedance as a continuous function. 27,39 This approach, however, increases computational burden as it requires that travel times be calculated between each patient location-provider location dyad, whereas the E2SFCA simply requires the creation of isochrones.…”

Modeling spatial access to cervical cancer screening services in Ondo State, Nigeria

“…Different catchment sizes were assigned to urban and rural locations and adjusted based on input and insights from the local team in Nigeria about the maximum and average travel times of clients at the regional hospitals. In general, catchment size tended to be larger in rural areas, and smaller in urban areas reflecting the case that rural residents were likely to travel longer distances to seek care in the cities [21,40].…”