Geographical accessibility and Kentucky's heart-related hospital services

Hare, Timothy S.; Barcus, Holly R.

doi:10.1016/j.apgeog.2007.07.004

Cited by 102 publications

(68 citation statements)

References 19 publications

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“…16 A review of access to general cardiac services in Kentucky that reported the spatial statistical comparison of the geographical distribution with service use and travel time to hospitals showed that people living in rural areas traveled further to services and that populations residing Ͼ45 minutes from health facilities were more likely to be socially and economically marginalized. 47 Another Australian study that used simple Google maps to measure access to PCI was consistent with our results, demonstrating that 78% of Australian cardiac catheterization laboratories were located in major cities and that a significant number of Australians could not access PCI within the time frames recommended in guidelines. [2][3][4][5][6][7][8][9][10][11][12][13]17 The findings in our study reflect the size and nature of the Australian continent, in which it appears that access to cardiac services may represent an all-or-nothing situation, with almost one third of the population (29%) outside the road distance (and time frame) for primary cardiac intervention.…”

Section: Discussionsupporting

confidence: 72%

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event

et al. 2012

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Background Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods and Results An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ≤1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%). Conclusions The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world.

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Section: Discussionsupporting

confidence: 72%

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event

et al. 2012

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“…GIS is the most common tool applied so far to spatial analysis. The capabilities of GIS to handle massive amounts of data over large geographic areas at fine levels of geographic details make it suitable to analyze accessibility to medical service providers (Harea & Barcus, 2007).…”

Section: Methodsmentioning

confidence: 99%

Hospital site selection using two-stage fuzzy multi-criteria decision making process

Soltani

Marandi

2011

JUEE

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Abstract:Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS). The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.

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“…Taking the localities as a unit of origin, an aggregation of values was done considering the average travel times from these localities to the district level for their incorporation as a dependent variable in the modelling. The travel times were integrated into diverse studies in order to model accessibility to primary health care centres/hospitals (Brabyn and Skelly, 2001;Hare and Barcus, 2007;Bagheri et al, 2009;Rodríguez, 2010;Munoz and Kallestal, 2012), where the location factor (population, health care centres) and the characteristics of the network were considered in order to obtain the travel time factor (speed and length of the road sections).…”

Section: Accessibility Modelling Methodsmentioning

confidence: 99%

Geographically weighted regression for modelling the accessibility to the public hospital network in Concepción Metropolitan Area, Chile

Bascuñán¹,

Rojas²

2016

Geospat Health

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Accessibility models in transport geography based on geographic information systems have proven to be an effective method in determining spatial inequalities associated with public health. This work aims to model the spatial accessibility from populated areas within the Concepción metropolitan area (CMA), the second largest city in Chile. The city's public hospital network is taken into consideration with special reference to socio-regional inequalities. The use of geographically weighted regression (GWR) and ordinary least squares (OLS) for modelling accessibility with socioeconomic and transport variables is proposed. The explanatory variables investigated are: illiterate population, rural housing, alternative housing, homes with a motorised vehicle, public transport routes, and connectivity. Our results identify that approximately 4.1% of the population have unfavourable or very unfavourable accessibility to public hospitals, which correspond to rural areas located south of CMA. Application of a local GWR model (0.87 R 2 adjusted) helped to improve the settings over the use of traditional OLS methods (multiple regression) (0.67 R 2 adjusted) and to find the spatial distribution of both coefficients of the explanatory variables, demonstrating the local significance of the model. Thus, accessibility studies have enormous potential to contribute to the development of public health and transport policies in turn to achieve equality in spatial accessibility to specialised health care.

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Geographical accessibility and Kentucky's heart-related hospital services

Cited by 102 publications

References 19 publications

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event

Hospital site selection using two-stage fuzzy multi-criteria decision making process

Geographically weighted regression for modelling the accessibility to the public hospital network in Concepción Metropolitan Area, Chile

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