Planning hierarchical hospital service areas for maternal care using a network optimization approach: A case study in Hubei, China

Abstract

Improving maternal health is one of the Sustainable Development Goals. Hospital service areas (HSAs), which contain most hospitalization behaviors at the local scale, are crucial for health care planning. However, little attention has been given to HSAs for maternal care and the hierarchy structure. Considering Hubei, central China, as a case study, this study aims to fill these gaps by developing a method for delineating hierarchical HSAs for maternal care using a network optimization approach. The approach is driven by actual patient flow data and has an explicit objective to maximize the modularity. It also establishes the hierarchical structure of maternal care HSAs, which is fundamental for the planning of hierarchical maternal care and referral systems. In our case study, 45 secondary HSAs and 22 tertiary HSAs are delineated to achieve maximal modularity. The HSAs perform well in terms of indices such as the Localization Index and Market Share Index. Furthermore, there is a complementary relationship between secondary and tertiary hospitals, which suggests the need for referral system planning. This study can provide evidence for the validity of the HSA and the planning of maternal care HSAs in China. It also provides transferable methods for planning hierarchical HSAs in other developing countries.

Analysis of Regional Medical Supply and Demand Network Characteristics Based on “Patient Flow Phenomenon”: A Case Study of the Core Area of the Wuhan Metropolitan Area

“…However, it does not extend to the impact of factors like medical insurance policies, hospital referral conditions, residents' income levels, economic development, and spatial setting on regional medical supply and demand patterns. This is due to the theoretical and gravity model-based nature of the medical network constructed in this study, which produces results distinct from existing studies [9] utilizing actual patient networks. For instance, our findings highlight Wuhan's significant Land 2024, 13, 142 20 of 22 role in regional medical supply and demand connections, reflecting its perceived status as a central resource hub.…”

“…Conversely, studies that construct medical networks based on actual patient flows, driven by the aim of 'equality of outcomes', concentrate on addressing social inequalities to achieve fair outcomes. These studies, however, often encounter issues such as difficulty in data collection, data timeliness, and compromised study precision [5,6,8,9]. By comparison, the approach used in this study for building a regional medical supply and demand network and analyzing its characteristics demonstrates greater sophistication and advancement".…”

“…The progress in communities' division outcomes is most notable in the spatial morphology of the communities. While prevailing research on medical service zoning in Hubei Province primarily conforms to city or county administrative boundaries [9], this study, through improved research accuracy, captures the intricate zoning morphology shaped by transportation and geographical factors at a metropolitan level. This deviation from traditional methods, which often rely on county-level data, facilitates a more precise assessment of regional supply and demand variations, especially those influenced by commuting patterns.…”

Spatial structure and proximity mechanism of cross-city patient mobility networks in the Yangtze River Economic Belt of China: Based on patient online evaluation data

“…Wang et al, 2021), these approaches may lead to a potential oversimplification of patient dynamics (Yan et al, 2022). Acknowledging these shortcomings, several researchers have shifted their focus to examining real-world healthcare utilization, employing actual medical records in their analysis (Ding et al, 2023;Tao et al, 2022;F. Wang et al, 2020;Q.…”