Journal of Transport & Health ( IF 3.613 ) Pub Date : 2020-08-26 , DOI: 10.1016/j.jth.2020.100911 Guangping Chen , Cassandra C. Wang , Pingbin Jin , Bingyan Xia , Liang Xiao , Siyun Chen , Jing Luo
Introduction
Population aging raises many fundamental questions for public health policymakers, one of which is how to address the inequity of medical services for older adults. Geographic information systems (GIS)-based accessibility has been widely employed to measure the inequity of access to healthcare facilities. However, the focus in literature lies generally on spatial patterns; few accessibility studies have focused on temporal inequity. This study focuses on the disparity of the elderly's healthcare inequity (EHI) in both spatial and temporal dimensions.
Methods
EHI is measured by the elderly's medical services accessibility (EMSA) scores. Based on a road network analysis with real-time traffic data acquired by a Python-based web crawler, a Gaussian two-step floating catchment area (2SFCA) method is employed to calculate EMSA scores. Sensitivity analysis is presented for three threshold times (i.e., 5, 15, and 30 min) and different intervals of a time of day (TOD) period.
Results
In the temporal patterns, the average EMSA (EMSA-avg) scores of daily variations vary from 0.0262 to 0.0556 at t0 = 5 min, from 0.0704 to 0.1073 at t0 = 15 min, and from 0.1734 to 0.2223 at t0 = 30 min. Meanwhile, three “low value intervals (LVIs)” exist in TOD period. In the spatial patterns, the areas with frequent traffic congestions or no nearby hospitals are characterized by low-level accessibility for the 5 min catchment, while the same level areas for the 30 min are far from the city centre and equipped with inconvenient public transportation.
Conclusions
The findings may help the policymakers in planning the medical service resources for the growing aging population and providing caregivers information for a timely and effective medical treatment.
中文翻译:
老年人医疗保健不平等的评估:时空视角
介绍
人口老龄化给公共卫生政策制定者提出了许多基本问题,其中之一就是如何解决老年人医疗服务的不平等问题。基于地理信息系统(GIS)的可访问性已被广泛用于衡量访问医疗保健设施的不平等性。但是,文学的焦点通常集中在空间模式上。可访问性研究很少集中于时间不平等。这项研究的重点是在空间和时间维度上老年人医疗保健不平等(EHI)的差异。
方法
EHI由老年人的医疗服务可及性(EMSA)分数来衡量。基于基于Python的Web爬虫获取的实时交通数据对道路网络进行分析,采用高斯两步浮动集水区(2SFCA)方法来计算EMSA得分。给出了三个阈值时间(即5、15和30分钟)和一天中不同时间间隔(TOD)的灵敏度分析。
结果
在时间模式中,每日变化的平均EMSA(EMSA-avg)得分在t 0 = 5分钟时从0.0262到0.0556,在t 0 = 15分钟时从0.0704到0.1073,在t 0 = 30时从0.1734到0.2223。分钟 同时,在TOD时段中存在三个“低值区间(LVI)”。在空间格局上,交通拥堵频繁或附近没有医院的地区的特点是5分钟流域的低层可及性,而30分钟相同水平的区域远离市中心,且公共交通不便。
结论
这些发现可能有助于决策者为不断增长的老龄化人口规划医疗服务资源,并为及时有效的医疗提供照顾者信息。