The potential for a population at a given location to utilize a health service can be estimated using a newly developed measure called the supply-concentric demand accumulation (SCDA) spatial availability index. Spatial availability is the amount of demand at the given location that can be satisfied by the supply of services at a facility, after discounting the intervening demand among other populations that are located nearer to a facility location than the given population location. This differs from spatial accessibility measures which treat absolute distance or travel time as the factor that impedes utilization. The SCDA is illustrated using pulmonary rehabilitation (PR), which is a treatment for people with chronic obstructive pulmonary disease (COPD). The spatial availability of PR was estimated for each Census block group in Georgia using the 1105 residents who utilized one of 45 PR facilities located in or around Georgia. Data was provided by the Centers for Medicare & Medicaid Services. The geographic patterns of the SCDA spatial availability index and the two-step floating catchment area (2SFCA) spatial accessibility index were compared with the observed PR utilization rate using bivariate local indicators of spatial association. The SCDA index was more associated with PR utilization (Morans I = 0.607, P < 0.001) than was the 2SFCA (Morans I = 0.321, P < 0.001). These results suggest that the measures of spatial availability may be a better way to estimate the health care utilization potential than measures of spatial accessibility.

中文翻译：

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使用以供应为中心的需求积累空间可用性指数估算卫生服务利用潜力：一项肺康复案例研究。

可以使用一种新开发的测量方法来估计给定位置的人口使用卫生服务的潜力，该测量方法称为以供应为中心的需求累积（SCDA）空间可用性指数。空间可用性是指在给定位置上的需求量减去在比给定人口位置更近于设施位置的其他人口之间的中间需求之后，可以通过设施中的服务供给来满足的需求量。这不同于将绝对距离或旅行时间视为阻碍利用的因素的空间可及性度量。使用肺康复（PR）说明了SCDA，这是一种用于慢性阻塞性肺疾病（COPD）的治疗方法。通过使用1佐治亚州的1105名居民，利用佐治亚州内或附近的45个公关设施之一，估计了PR的空间可用性。数据由医疗保险和医疗补助服务中心提供。使用空间关联的双变量局部指标，将SCDA空间可利用性指数和两步浮动集水区（2SFCA）空间可及性指数的地理模式与观测的PR利用率进行了比较。与2SFCA（Morans I = 0.321，P <0.001）相比，SCDA指数与PR利用率相关性更高（Morans I = 0.607，P <0.001）。这些结果表明，与空间可及性度量相比，空间可利用性度量可能是估计医疗保健利用潜力的更好方法。