Measuring spatio-temporal disparity of location-based accessibility to emergency medical services

Xiong, Qingrong; Xing, Lijun; Wang, Liye; Ding, Yimei; Liu, Yanfang

doi:10.1016/j.healthplace.2022.102766

Cited by 15 publications

(11 citation statements)

References 67 publications

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“…Some measures (N = 3) employed time-dependent travel times using real-time traffic data. Other measures used time-dependent demand [ 63 ], time-dependent supply [ 64 ], or a combination of time-dependent travel time, demand, and supply [ 65 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…Approximating reality: Many of the methodological developments stem from attempts to make the spatial access measure better reflect reality. Distance decay within the catchment area (e.g., [ 12 , 32 , 67 ]) better reflects real-world travel friction; variable catchment area sizes allow for integration of real-world differences in willingness to travel (e.g., [ 13 , 35 , 68 ]); multiple transportation modes allow for modeling real-world travel behavior (e.g., [ 14 , 50 , 51 ]); and time-dependent access captures real-world temporal variability in access (e.g., [ 64 – 66 ]). While this makes spatial access measures more realistic, it also comes at a cost.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gravity models for potential spatial healthcare access measurement: a systematic methodological review

Stacherl,

Sauzet

2023

Int J Health Geogr

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Background Quantifying spatial access to care—the interplay of accessibility and availability—is vital for healthcare planning and understanding implications of services (mal-)distribution. A plethora of methods aims to measure potential spatial access to healthcare services. The current study conducts a systematic review to identify and assess gravity model-type methods for spatial healthcare access measurement and to summarize the use of these measures in empirical research. Methods A two-step approach was used to identify (1) methodological studies that presented a novel gravity model for measuring spatial access to healthcare and (2) empirical studies that applied one of these methods in a healthcare context. The review was conducted according to the PRISMA guidelines. EMBASE, CINAHL, Web of Science, and Scopus were searched in the first step. Forward citation search was used in the second step. Results We identified 43 studies presenting a methodological development and 346 empirical application cases of those methods in 309 studies. Two major conceptual developments emerged: The Two-Step Floating Catchment Area (2SFCA) method and the Kernel Density (KD) method. Virtually all other methodological developments evolved from the 2SFCA method, forming the 2SFCA method family. Novel methodologies within the 2SFCA family introduced developments regarding distance decay within the catchment area, variable catchment area sizes, outcome unit, provider competition, local and global distance decay, subgroup-specific access, multiple transportation modes, and time-dependent access. Methodological developments aimed to either approximate reality, fit a specific context, or correct methodology. Empirical studies almost exclusively applied methods from the 2SFCA family while other gravity model types were applied rarely. Distance decay within catchment areas was frequently implemented in application studies, however, the initial 2SFCA method remains common in empirical research. Most empirical studies used the spatial access measure for descriptive purposes. Increasingly, gravity model measures also served as potential explanatory factor for health outcomes. Conclusions Gravity models for measuring potential spatial healthcare access are almost exclusively dominated by the family of 2SFCA methods—both for methodological developments and applications in empirical research. While methodological developments incorporate increasing methodological complexity, research practice largely applies gravity models with straightforward intuition and moderate data and computational requirements.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gravity models for potential spatial healthcare access measurement: a systematic methodological review

Stacherl,

Sauzet

2023

Int J Health Geogr

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“…The timely response of EMS, including arriving at the scene and transporting the patient to the hospital, is an essential adaptive factor for extreme heat events, as a delay may result in severe impairment or heat-related death (Cui et al, 2021; Hu et al, 2020; Xiong et al, 2022). As presented in Figure 4(a), the highest levels of concurrence in heat vulnerability and the total response time of heat-related EMS incidents appear in block groups in the peri-urban fringes in the east and north Austin (i.e., Pflugerville), showing an overlapped vulnerability in heat and EMS services.…”

Section: Resultsmentioning

confidence: 99%

Evaluating the effects of heat vulnerability on heat-related emergency medical service incidents: Lessons from Austin, Texas

Seong

Jiao

Mandalapu

2022

Environment and Planning B: Urban Analytics and City Science

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Extreme heat exposure and sensitivity have been a growing concern in urban regions as the effects of extreme heat pose a threat to public health, the water supply, and the infrastructure. Heat-related illnesses demand an immediate Emergency Medical Service (EMS) response since they might result in death or serious disability if not treated quickly. Despite increased concerns about urban heat waves and relevant health issues, a limited amount of research has investigated the effects of heat vulnerability on heat-related illnesses. This study explores the geographical distribution of heat vulnerability in the city of Austin and Travis County areas of Texas and identifies neighborhoods with a high degree of heat vulnerability and restricted EMS accessibility. We conducted negative binomial regressions to investigate the effects of heat vulnerability on heat-related EMS incidents. Heat-related EMS calls have increased in neighborhoods with more impervious surfaces, Hispanics, those receiving social benefits, people living alone, and the elderly. Higher urban capacity, including efficient road networks, water areas, and green spaces, is likely to reduce heat-related EMS incidents. This study provides data-driven evidence to help planners prioritize vulnerable locations and concentrate local efforts on addressing heat-related health concerns.

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“…In addition to this, Sun et al [20] also quantitatively investigated the level of medical accessibility development from 2000 to 2018 for 186 countries around the world. Furthermore, a number of studies have calculated "accessibility of emergency medical care" as a different perspective from that of medical accessibility in normal times [21][22][23][24][25]. These are important studies to evaluate public health services in emergency situations.…”

Section: Studies Focusing On Elderly Patients Living In Depopulated A...mentioning

confidence: 99%

Quantitative Evaluation of Difficulty in Visiting Hospitals for Elderly Patients in Depopulated Area in Japan: Using National Health Insurance Data

Morisaki,

Fujiu,

Takayama

et al. 2023

Sustainability

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Depopulation is occurring in rural areas of Japan due to the outflow of the population to urban areas, the declining birthrate, and the aging population. Within depopulated areas, there is a problem of declining accessibility to medical facilities due to the decline of the medical system and transportation infrastructure. Therefore, measuring accessibility to medical facilities in underpopulated areas is an important issue. In this study, we calculated an accessibility index (APMI) to medical facilities in underpopulated areas in Japan using geographical information such as elevation, distance to medical facilities, and distance to bus stops. Furthermore, we estimated the number of patients who are considered to have difficulty visiting hospitals by using the National Health Insurance data (KDB) owned by all local governments in Japan. Through the analysis in this study, it became clear that accessibility was extremely low in the mountainous area of Hakui, Ishikawa Prefecture, and the number of patients living there could be determined. In addition, priority areas for improving the environment for visiting the hospital were identified.

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Measuring spatio-temporal disparity of location-based accessibility to emergency medical services

Cited by 15 publications

References 67 publications

Gravity models for potential spatial healthcare access measurement: a systematic methodological review

Gravity models for potential spatial healthcare access measurement: a systematic methodological review

Evaluating the effects of heat vulnerability on heat-related emergency medical service incidents: Lessons from Austin, Texas

Quantitative Evaluation of Difficulty in Visiting Hospitals for Elderly Patients in Depopulated Area in Japan: Using National Health Insurance Data

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