Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

Luo, Jing; Tian, Li; Luo, Lei; Hong, Yong-Geun; Wang, Fahui

doi:10.1155/2017/2094654

Cited by 41 publications

(42 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, one methodological limitation often mentioned in research considering accessibility concerns the fact that studies failed to include behavior outside the study area [ 17 , 28 – 39 ]. Known as the edge effect, it is central to this paper.…”

Section: Introductionmentioning

confidence: 99%

Does the edge effect impact on the measure of spatial accessibility to healthcare providers?

et al. 2017

View full text Add to dashboard Cite

BackgroundSpatial accessibility indices are increasingly applied when investigating inequalities in health. Although most studies are making mentions of potential errors caused by the edge effect, many acknowledge having neglected to consider this concern by establishing spatial analyses within a finite region, settling for hypothesizing that accessibility to facilities will be under-reported. Our study seeks to assess the effect of edge on the accuracy of defining healthcare provider access by comparing healthcare provider accessibility accounting or not for the edge effect, in a real-world application.MethodsThis study was carried out in the department of Nord, France. The statistical unit we use is the French census block known as ‘IRIS’ (Ilot Regroupé pour l’Information Statistique), defined by the National Institute of Statistics and Economic Studies. The geographical accessibility indicator used is the “Index of Spatial Accessibility” (ISA), based on the E2SFCA algorithm. We calculated ISA for the pregnant women population by selecting three types of healthcare providers: general practitioners, gynecologists and midwives. We compared ISA variation when accounting or not edge effect in urban and rural zones. The GIS method was then employed to determine global and local autocorrelation. Lastly, we compared the relationship between socioeconomic distress index and ISA, when accounting or not for the edge effect, to fully evaluate its impact.ResultsThe results revealed that on average ISA when offer and demand beyond the boundary were included is slightly below ISA when not accounting for the edge effect, and we found that the IRIS value was more likely to deteriorate than improve. Moreover, edge effect impact can vary widely by health provider type. There is greater variability within the rural IRIS group than within the urban IRIS group. We found a positive correlation between socioeconomic distress variables and composite ISA. Spatial analysis results (such as Moran’s spatial autocorrelation index and local indicators of spatial autocorrelation) are not really impacted.ConclusionOur research has revealed minor accessibility variation when edge effect has been considered in a French context. No general statement can be set up because intensity of impact varies according to healthcare provider type, territorial organization and methodology used to measure the accessibility to healthcare. Additional researches are required in order to distinguish what findings are specific to a territory and others common to different countries. It constitute a promising direction to determine more precisely healthcare shortage areas and then to fight against social health inequalities.

show abstract

Section: Introductionmentioning

confidence: 99%

Does the edge effect impact on the measure of spatial accessibility to healthcare providers?

et al. 2017

View full text Add to dashboard Cite

show abstract

“…To evaluate geographical accessibility to ECS care was used the two-step floating catchment area (2SFCA) method [ 28 , 29 ]. With this approach it was possible assess the accessibility by the interaction of two geographic characteristics: (a) volume of available hospital beds in each hospital to a determined population within 1 h of travel distance, and (b) the proximity of services to that population, within a 60 km buffer from each municipality centroid.…”

Section: Methodsmentioning

confidence: 99%

Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil

Rocha

Silva

Amaral

et al. 2017

Int J Equity Health

View full text Add to dashboard Cite

BackgroundUnequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges.MethodsThe present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals.ResultsThe analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people.ConclusionsThere is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access to emergency and surgical care. However more investments in are necessary to improve small hospitals capabilities to fill this gap.

show abstract

“…In a recent study, Luo et al (2017) propose a framework, termed 'two-step optimization for spatial accessibility improvement (2SO4SAI)', to integrate the dual objectives of efficiency and equality. Based on the case study of health-care planning in a rural county in China, they adopt a sequential decision-making approach.…”

Section: Spatial Optimization Towards a Balance In Efficiency And Equmentioning

confidence: 99%

“…Therefore, four sequential planning problems can be formulated: 1A-2A, 1A-2B, 1B-2A, and 1B-2B (as listed in Table 1). Note scenario 1A-2B is implemented in Luo et al (2017), and three other scenarios remain to be explored.…”

Section: Spatial Optimization Towards a Balance In Efficiency And Equmentioning

confidence: 99%

Why public health needs GIS: a methodological overview

Wang

2019

Annals of GIS

Self Cite

101

View full text Add to dashboard Cite

The short paper provides an overview on how geographic issues have become increasingly relevant to public health research and policy, particularly through the lens of geographic information systems (GIS). It covers six themes with an emphasis on methodological issues. (1) Our health-related behaviour varies across geographic settings, so should public health policy. (2) Facilities (supply) and patients (demand) in a health-care market interact with each other across geopolitical borders, and measures of healthcare accessibility need to capture that. (3) Our health outcome is the result of joint effects of individual attributes and neighbourhood characteristics, and an adequate definition of neighbourhood is critical for assessing neighbourhood effect. (4) Disease rates in areas of small population are unreliable, and one effective way to mitigate the problem is to construct a larger, internally homogenous and comparable area unit. (5) Defining a scientific geographic unit for health-care market is critical for researchers, practitioners, and policy makers to evaluate health-care delivery, and GIS enables us to define the unit (e.g. primary care service areas, hospital service areas, and cancer service areas) automatically, efficiently and optimally. (6) Aside from various optimization objectives around 'efficiency', it is as important to plan the location and allocation of health-care resources towards maximum equality in health-care access. Case studies are cited to illustrate each theme.

show abstract

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

Cited by 41 publications

References 21 publications

Does the edge effect impact on the measure of spatial accessibility to healthcare providers?

Does the edge effect impact on the measure of spatial accessibility to healthcare providers?

Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil

Why public health needs GIS: a methodological overview

Contact Info

Product

Resources

About