Explaining Accessibility and Satisfaction Related to Healthcare: A Mixed-Methods Approach

Cabrera-Barona, Pablo; Blaschke, Thomas; Kienberger, Stefan

doi:10.1007/s11205-016-1371-9

Cited by 36 publications

(30 citation statements)

References 72 publications

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“…This indicator could be used as a simple contextual variable. In the study area, the importance of having social insurance for healthcare accessibility and healthcare satisfaction has been reported at the individual-level [26]. It is likely that the area-level indicator of having social insurance, as a simple measure of health inequality, may be linked to area-level measures of spatial accessibility to healthcare.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Cabrera-Barona

2017

Urban Science

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Self-reported health is considered a health outcome related to neighborhood characteristics. This study analyzes the influence of urban multi-criteria deprivation and spatial accessibility to healthcare on individual self-reported health from a case study carried out in the city of Quito, Ecuador. A multi-criteria deprivation index and two alternative scenarios of this index were generated. A gravity-based measure of spatial accessibility to healthcare was also calculated. The neighborhood effects of deprivation measures and spatial accessibility to healthcare on individual self-reported health were evaluated by applying multilevel models. Significant neighborhood effects were found in two of the three applied multilevel models. This study contributes evidence of neighborhood effects on health outcomes, and can support urban planners and policy-makers in the reduction of urban health-related inequalities.

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Section: Discussionmentioning

confidence: 99%

“…The measure of self-reported health was extracted from a survey carried out in Quito in the months of July, August, and October of 2014 [26]. This survey utilized a two-stage sampling strategy.…”

Section: Study Area Data Sources and The Measure Of Self-reported Hementioning

confidence: 99%

Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Cabrera-Barona

2017

Urban Science

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“…We used the index of composite healthcare satisfaction proposed by Cabrera-Barona et al (2016a). This index uses three indicators: waiting time to receive healthcare attention after arriving at the primary healthcare service (T), the quality of the attention received, as reported by the patient (Q), and the opportunities (supply capacity) offered by the service (S).…”

Section: Calculation Of the Index Of Healthcare Satisfactionmentioning

confidence: 99%

Deprivation, Healthcare Accessibility and Satisfaction: Geographical Context and Scale Implications

Cabrera-Barona

Blaschke

Gaona

2017

Appl. Spatial Analysis

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Indices explaining health phenomena are important tools for identifying and investigating health inequalities and to support policy making. Some of these indices are expressed at area-level, and the investigation of the areal influences of these indices on individual health outcomes have scale and geographical contextual implications that need to be assessed. In this study we calculated two area-level indices: one deprivation index and one index of healthcare accessibility. Using multilevel modelling, we calculated the area-level influences of these indices on an individual-level index of healthcare satisfaction considering three kinds of areas or contexts: a context of deprivation, a context of healthcare accessibility and a context combining the two characteristics of healthcare accessibility and deprivation. We evaluated two kinds of geographical problems using the statistical results of these area-level influences: the modifiable areal unit problem (MAUP) and the uncertain geographic context problem (UGCoP). Regarding the MAUP we evaluated the scale effects at two scales: census blocks and census tracts. Regarding the UGCoP we evaluated the differences in areal influences between the three kinds of contexts for both scales. The case study area was the city of Quito, Ecuador. The results of the performed analyses showed no severe MAUP and UGCoP, and revealed important evidence of the area-level influence of deprivation and healthcare accessibility on healthcare satisfaction.

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“…These indicators were chosen because they are related to basic human needs, represent social disadvantages, and can be related to health issues [38,39,47,[49][50][51]. Information pertaining to these indicators was extracted from the 2010 Ecuadorian Population and Housing Census.…”

Section: Social Indicators Estimationmentioning

confidence: 99%

Scale-Free Relationships between Social and Landscape Factors in Urban Systems

Wei¹,

Padgham²,

Cabrera-Barona³

et al. 2017

Sustainability

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Urban planners and ecologists have long debated the relationship between the structure of urban landscapes and social activities. There have, however, been very few discussions as to whether any such relationships might depend on the scales of observation. This work applies a hierarchical zoning technique to data from the city of Quito, Ecuador, to examine how relationships between typical spatial landscape metrics and social indicators depend on zoning scales. Our results showed that the estimates of both landscape heterogeneity features and social indicators significantly depend on the zoning scale. The mean values of the typical landscape metrics and the social indicators all exhibited predictable responses to a changing zoning scale, suggesting a consistent and significant scaling relationship within the multiple zoning scales. Yet relationships between these pairs of variables remain notably invariant to scale. This quantitative demonstration of the scale-free nature of the relationship between landscape characteristics and social indicators furthers our understanding of the relationships between landscape structures and social aspects of urban spaces, including deprivation and public service accessibility. The relationships between social indicators and one typical landscape aggregation metric (represented as the percentage of like adjacencies) were nevertheless significantly dependent on scale, suggesting the importance of zoning scale decisions for analyzing the relationships between the social indicators and the landscape characteristics related with landscape adjacency. Aside from this typical landscape aggregation metric, the general invariance to the zoning scale of relationships between landscape structures and socioeconomic indicators in Quito suggests the importance of applying these scale-free relationships in understanding complex socio-ecological systems in other cities, which are shaped by the conflated influences of both anthropogenic and natural factors. Moreover, this scale-free behavior of landscape-social relationships challenges the traditional modifiable area unit problem, and provides mechanistic insight into the conflicts and compatibilities between human activities and human-induced land use change.

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Explaining Accessibility and Satisfaction Related to Healthcare: A Mixed-Methods Approach

Cited by 36 publications

References 72 publications

Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Deprivation, Healthcare Accessibility and Satisfaction: Geographical Context and Scale Implications

Scale-Free Relationships between Social and Landscape Factors in Urban Systems

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