scholarly journals Assessing emergency healthcare accessibility in the Salton Sea region of Imperial County, California

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253301
Author(s):  
Preeti Juturu
Keyword(s):  
Supply And Demand ◽  
Healthcare Access ◽  
Salton Sea ◽  
Science Methods ◽  
Travel Times ◽  
Healthcare Facilities ◽  
Census Tracts ◽  
Traffic Conditions ◽  
Average Travel Time ◽  
Negative Health Outcomes

The area surrounding California’s Salton Sea, which lies within Riverside and Imperial counties, has particularly negative health outcomes. Imperial County, a primarily rural region that encompasses the lake, has pediatric asthma-related emergency healthcare visits that double the state average. This paper seeks to assess the level of emergency healthcare access in the Salton Sea region of Imperial County, drawing from spatial science methods. For this study, the "Salton Sea region" is defined as all Imperial County census tracts that include the Salton Sea within its boundaries. To measure "access," this study calculated driving travel times from census tracts to hospitals within Imperial County rather than Euclidean distance to account for geography and urban infrastructures such as road networks and traffic conditions. This study also used the Rational Agent Access Model, or RAAM, to assess access. RAAM scores account for the supply and demand for hospitals in addition to travel times. Results showed that the average travel time for Salton Sea region residents to drive to Imperial County emergency healthcare facilities ranged from 50–61 minutes, compared to 14–20 minutes for other Imperial County tracts. RAAM scores, compared to other Imperial County tracts, were about 30% higher in the Salton Sea region, meaning that healthcare supply is limited in the region. State and county policy should account for spatial inaccessibility to healthcare institutions in order to address emergency healthcare access.

scholarly journals The Effect of Route-choice Strategy on Transit Travel Time Estimates

2019 ◽  
Author(s):  
Nate Wessel ◽  
Steven Farber
Keyword(s):  
Travel Time ◽  
Shortest Path ◽  
Imperfect Information ◽  
Optimal Path ◽  
Shortest Paths ◽  
Route Choice ◽  
Travel Times ◽  
Selection Strategies ◽  
Time Estimates ◽  
Average Travel Time

Estimates of travel time by public transit often rely on the calculation of a shortest-path between two points for a given departure time. Such shortest-paths are time-dependent and not always stable from one moment to the next. Given that actual transit passengers necessarily have imperfect information about the system, their route selection strategies are heuristic and cannot be expected to achieve optimal travel times for all possible departures. Thus an algorithm that returns optimal travel times at all moments will tend to underestimate real travel times all else being equal. While several researchers have noted this issue none have yet measured the extent of the problem. This study observes and measures this effect by contrasting two alternative heuristic routing strategies to a standard shortest-path calculation. The Toronto Transit Commission is used as a case study and we model actual transit operations for the agency over the course of a normal week with archived AVL data transformed into a retrospective GTFS dataset. Travel times are estimated using two alternative route-choice assumptions: 1) habitual selection of the itinerary with the best average travel time and 2) dynamic choice of the next-departing route in a predefined choice set. It is shown that most trips present passengers with a complex choice among competing itineraries and that the choice of itinerary at any given moment of departure may entail substantial travel time risk relative to the optimal outcome. In the context of accessibility modelling, where travel times are typically considered as a distribution, the optimal path method is observed in aggregate to underestimate travel time by about 3-4 minutes at the median and 6-7 minutes at the \nth{90} percentile for a typical trip.

scholarly journals Mapping physical access to healthcare for older adults in sub-Saharan Africa: A cross-sectional analysis with implications for the COVID-19 response

2020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Travel Time ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Travel Times ◽  
Healthcare Resources ◽  
Healthcare Facilities ◽  
Sub Saharan ◽  
Physical Access

Background: SARS-CoV-2, the virus causing coronavirus disease 2019 (COVID-19), is rapidly spreading across sub-Saharan Africa (SSA). Hospital-based care for COVID-19 is particularly often needed among older adults. However, a key barrier to accessing hospital care in SSA is travel time. To inform the geographic targeting of additional healthcare resources, this study aimed to determine the estimated travel time at a 1km x 1km resolution to the nearest hospital and to the nearest healthcare facility of any type for adults aged 60 years and older in SSA. Methods: We assembled a unique dataset on healthcare facilities' geolocation, separately for hospitals and any type of healthcare facility (including primary care facilities) and including both private- and public-sector facilities, using data from the OpenStreetMap project and the KEMRI Wellcome Trust Programme. Population data at a 1km x 1km resolution was obtained from WorldPop. We estimated travel time to the nearest healthcare facility for each 1km x 1km raster using a cost-distance algorithm. Findings: 9.6% (95% CI: 5.2% - 16.9%) of adults aged 60 and older years had an estimated travel time to the nearest hospital of longer than six hours, varying from 0.0% (95% CI: 0.0% - 3.7%) in Burundi and The Gambia, to 40.9% (95% CI: 31.8% - 50.7%) in Sudan. 11.2% (95% CI: 6.4% - 18.9%) of adults aged 60 years and older had an estimated travel time to the nearest healthcare facility of any type (whether primary or secondary/tertiary care) of longer than three hours, with a range of 0.1% (95% CI: 0.0% - 3.8%) in Burundi to 55.5% (95% CI: 52.8% - 64.9%) in Sudan. Most countries in SSA contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of more than 12 hours and to the nearest healthcare facility of any type of more than six hours. The median travel time to the nearest hospital for the fifth of adults aged 60 and older years with the longest travel times was 348 minutes (IQR: 240 - 576 minutes) for the entire SSA population, ranging from 41 minutes (IQR: 34 - 54 minutes) in Burundi to 1,655 minutes (IQR: 1065 - 2440 minutes) in Gabon. Interpretation: Our high-resolution maps of estimated travel times to both hospitals and healthcare facilities of any type can be used by policymakers and non-governmental organizations to help target additional healthcare resources, such as new make-shift hospitals or transport programs to existing healthcare facilities, to older adults with the least physical access to care. In addition, this analysis shows precisely where population groups are located that are particularly likely to under-report COVID-19 symptoms because of low physical access to healthcare facilities. Beyond the COVID-19 response, this study can inform countries' efforts to improve care for conditions that are common among older adults, such as chronic non-communicable diseases.

Evaluation of Online Travel Time Estimators and Predictors

2000 ◽  
Vol 1719 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Charles D. R. Lindveld ◽  
Remmelt Thijs ◽  
Piet H. L. Bovy ◽  
Nanne J. Van der Zijpp
Keyword(s):  
Travel Time ◽  
Traffic Management ◽  
Negative Impact ◽  
Test Site ◽  
Estimation Accuracy ◽  
Travel Times ◽  
Congested Traffic ◽  
Traffic Conditions ◽  
Loop Detectors ◽  
Online Travel

Travel time is an important characteristic of traffic conditions in a road network. Up-to-date travel time information is important in dynamic traffic management. Presented are the findings of a recently completed research and evaluation program called DACCORD, regarding the evaluation of tools for online estimation and prediction of travel times by using induction loop detector data. Many methods exist with which to estimate and predict travel time by using induction loop data. Several of these methods were implemented and evaluated in three test sites in France, Italy, and the Netherlands. Both cross-tool and cross-site evaluations have been carried out. Travel time estimators based on induction loop detectors were evaluated against observed travel times and were seen to be reasonably accurate (10 percent to 15 percent root mean square error proportional) across different sites for uncongested to lightly congested traffic conditions. The evaluation period varied by site from 4 to 30 days. Results were seen to diverge at higher congestion levels: at one test site, congestion levels were seen to have a strong negative impact on estimation accuracy; at another test site, accuracy was maintained even in congested conditions.

scholarly journals Travel-time, bikes, and HIV elimination in Malawi: a geospatial modeling analysis

2020 ◽  
Author(s):  
Laurence Palk ◽  
Justin T Okano ◽  
Luckson Dullie ◽  
Sally Blower
Keyword(s):  
Travel Time ◽  
Rural Areas ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Travel Times ◽  
Geospatial Modeling ◽  
Healthcare Facilities ◽  
Fast Tracking ◽  
Sub Saharan

Background: UNAIDS has prioritized Malawi and 21 other countries in sub-Saharan Africa (SSA) for "fast-tracking" the end of their HIV epidemics. To achieve elimination requires treating 90% of people living with HIV (PLHIV); coverage is already fairly high (70-75%). However, many individuals in SSA have to walk to access healthcare. We use data-based geospatial modeling to determine whether the need to travel long distances to access treatment and limited transportation in rural areas are barriers to HIV elimination in Malawi. Additionally, we evaluate the effect on treatment coverage of increasing the availability of bicycles in rural areas. Methods: We build a geospatial model that we use to estimate, for every PLHIV, their travel-time to access HIV treatment if driving, bicycling, or walking. We estimate the travel-times needed to achieve 70% or 90% coverage. Our model includes a spatial map of healthcare facilities (HCFs), the geographic coordinates of residencies for all PLHIV, and an "impedance" map. We quantify impedance using data on road/river networks, land cover, and topography. Findings: To cross an area of one km2 in Malawi takes from ~60 seconds (driving on main roads) to ~60 minutes (walking in mountainous areas); ~80% of PLHIV live in rural areas. At ~70% coverage, HCFs can be reached within: ~45 minutes if driving, ~65 minutes if bicycling, and ~85 minutes if walking. Increasing coverage above ~70% will become progressively more difficult. To achieve 90% coverage, the travel-time for many PLHIV (who have yet to initiate treatment) will be almost twice as long as those currently on treatment. Increasing bicycle availability in rural areas reduces round-trip travel-times by almost one hour (in comparison with walking), and could substantially increase coverage levels. Interpretation: Geographic inaccessibility to treatment coupled with limited transportation in rural areas are substantial barriers to reaching 90% coverage in Malawi. Increased bicycle availability could help eliminate HIV. Funding: National Institute of Allergy and Infectious Diseases

scholarly journals Drones Optimized Therapy System (DrOTS): Use of Drones for Tuberculosis Diagnosis in Nepal

2019 ◽  
pp. 14
Author(s):  
Uttam Pudasaini
Keyword(s):  
Public Health ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Access To Health Care ◽  
Health Workers ◽  
Healthcare Access ◽  
Health Care Facilities ◽  
Health Centers ◽  
Diagnostic Tools ◽  
Healthcare Facilities

Over 50% of the total Nepalese population lives in hilly and mountainous areas with extremely poor transportation and access to health care facilities. With advanced health centers concentrated only in urban areas, and diagnostic laboratories not being present in most primary healthcare facilities, majority of people are forced to have to walk by foot, in an average 6-8 hours, to access proper healthcare facilities. Drone Optimized Therapy System, (DrOTS) aims to improve access to healthcare access in rural villages of Nepal. The pilot phase currently involved improving the accessibility of Tuberculosis diagnostic tests by linking communit y health workers (CHWs) with state-of-the-art diagnostic tools (GeneXpert) via drones in two municipalities of Pyuthan district, Nepal. The drones fly from central Hospitals to remote healthcare centers and bring back sputum samples for diagnosis. The purpose of this project is to assist the Ministry of Health and Population (MoHP) and National Tuberculosis Center (NTC) by generating the data necessary to assess the suitability of the drones-based services for nationwide expansion. The aerial distance between any two points being lesser than the actual road distance, drone technology has come out as a very popular tool in transporting medical samples/medicines between health centers. Drones can be used as crucial tools to connect primary healthcare facilities to hospitals by delivering patient information such as blood, urine, sputum, stool etc. samples required for diagnosis from primary facilities to hospitals, and medicines from hospitals to patients in nearby rural locations for treatment. The project team consists of multisector experts; Public Health- Birat Nepal Medical Trust (BNMT), Drones & Tech - WeRobotics, Nepal Flying Labs & DroNepal, Research: The Liverpool School of Tropical Medicine, Govt. stakeholders: MoHP Nepal, the National TB Center and the District Public Health Office (DPHO Pyuthan) is supported by Stony Brook University and the Simons Foundation.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 14

Metering Ramps to Divert Traffic around Bottlenecks

2005 ◽  
Vol 1925 (1) ◽  
pp. 12-19 ◽  
Author(s):  
James H. Banks
Keyword(s):  
Travel Time ◽  
Ramp Metering ◽  
Travel Times ◽  
Alternate Route ◽  
Traffic Conditions

Three elementary cases, with ramp metering used to reduce delay by diverting traffic around bottlenecks, are analyzed. In these cases ( a) travel times on an alternate route bypassing the bottleneck are insensitive to flow on the alternate route, ( b) the alternate route is undersaturated but travel times are sensitive to flow, and ( c) the alternate route is oversaturated. Travel time equilibria and traffic assignments are relatively straightforward in all cases provided that equilibria in Cases b and c are assumed to be approximate and traffic assignments are based on drivers’ expectations about traffic conditions prevailing at particular times of day. A metering strategy intended to minimize delay is proposed. This strategy is expressed in terms of the order in which metering is initiated at different ramps and is similar to one previously proposed to maximize output to exits upstream of the bottleneck.

scholarly journals Pharmacy Vaccinations

2021 ◽  
Vol 12 (2) ◽  
pp. 12-16
Author(s):  
R. Oehlmann ◽  
A. Czirfusz
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Healthcare Access ◽  
The United States ◽  
Healthcare Systems ◽  
Vaccination Rate ◽  
Chronic Illnesses ◽  
Healthcare Facilities ◽  
Effective Strategies ◽  
The World

The vaccination rate is on the decline as parents avoid making frequent visits to healthcare facilities to visit doctors. The high cost of healthcare access in Germany, the United States, and other parts of the world has resulted in many people remaining under vaccinated or unvaccinated. The rate of pandemic outbreaks in Europe has highlighted the significance of improved communication and education about the safety and the efficacy of vaccinations alongside effective strategies of reducing the rate of disease transmission1 . Pandemics have unprecedented impacts on the families’ health and pressure on healthcare systems in Europe. During pandemics, there is widespread fear in families concerning how the pandemics will affect families and communities more especially to the compromised people in society, such as pregnant women and people with chronic illnesses. Although pharmaceutical practices are under intensive scrutiny, pharmacies' vaccinations comprise an important element in the healthcare system for pandemic diseases.

Is Medical Tourism Really Unethical? An Alternate Perspective for Developing Countries

2021 ◽  
pp. 245513332110623
Author(s):  
Divya Chaudhry
Keyword(s):  
Developing Countries ◽  
Medical Tourism ◽  
Healthcare Access ◽  
Public Healthcare ◽  
Global Public Health ◽  
Healthcare Facilities ◽  
Equity Issues ◽  
Opting Out ◽  
Ethical Concerns ◽  
Academic Literature

This article makes a case for leveraging medical tourism (MT) from the perspective of improving healthcare access in developing countries. The expansion of MT at an unprecedented rate has given rise to a number of ethical concerns in both home and destination countries. Ethical debates in this field have transcended the realm of global public health and have emerged across various disciplines including development, social justice, legal, trade and policy studies. Much of the academic literature in these domains has categorically held MT responsible for commodification of healthcare, creating a duality in healthcare systems of developing countries and making healthcare inaccessible and unaffordable for the disadvantaged sections of the population. While all these claims normatively seem justified, this article asserts that despite the several ethical concerns that have been raised, MT may not necessarily exacerbate healthcare equity issues in developing countries. In fact, MT may benefit destination countries by creating a highly specialised private sector which may provide services not only to foreign patients but also to wealthier domestic patients. Voluntary opting-out of domestic patients from public healthcare will result in decongestion of public healthcare facilities, which in turn could be accessed to a greater extent by the underprivileged population at affordable cost. In addition to contributing to the limited academic literature on this particular aspect of MT, this article presents an alternate view to promote MT in developing countries from the perspective of addressing challenges related to healthcare access.

A comparative analysis of information provision strategies for parking variable message sign display problems

2020 ◽  
Vol 39 (3) ◽  
pp. 2725-2735
Author(s):  
Xun-You Ni ◽  
Weite Lu ◽  
Chunqin Zhang ◽  
Yong Liu ◽  
Jing Zhao
Keyword(s):  
Comparative Analysis ◽  
Information Provision ◽  
Threshold Value ◽  
Agent Based ◽  
Variable Message Signs ◽  
Traffic Conditions ◽  
Average Travel Time ◽  
Parking Lot ◽  
Message Signs ◽  
Urban Parking

Parking spaces are insufficient and are plagued by over-consumption in hot areas. To assist drivers easily in identifying available parking spaces, parking variable message signs are commonly adopted to display information on space availability. This paper analyzes the performance of various information provision strategies. To achieve this objective, we first present the mechanisms of the information provision strategies. Then, the information provision strategies are classified into three categories: regular, symmetric, and discriminative. The regular strategies provide the collected parking information directly to drivers; the symmetric schemes employ the equal threshold values for all parking lots; and the discriminative schedules adopt an independent threshold value for each parking lot. The threshold value provides an upper limit for the Space Occupancy Percentage (SOP): when the SOP is larger than the threshold value, the parking lot status becomes FULL; otherwise, it is displayed having available spaces. Finally, an agent-based simulation model is introduced to describe the parking and traffic conditions. The results indicate that both the symmetric and discriminative strategies significantly decrease the highest failure rate and average travel time, whereas the latter performs better. The results of this comparative analysis can assist in the configuration and operation of an urban parking guidance and information system.

scholarly journals Robust Stop-Skipping at the Tactical Planning Stage with Evolutionary Optimization

2019 ◽  
Vol 2673 (3) ◽  
pp. 611-623 ◽  
Author(s):  
Konstantinos Gkiotsalitis
Keyword(s):  
Travel Time ◽  
Solution Space ◽  
Minimax Principle ◽  
Tactical Planning ◽  
Travel Times ◽  
Worst Case ◽  
Planning Stage ◽  
Traffic Conditions ◽  
Time Variations ◽  
Improved Performance

The planning of stop-skipping strategies based on the expected travel times of bus trips has a positive effect in practice only if the traffic conditions during the daily operations do not deviate significantly from those expected. For this reason, we propose a non-deterministic approach which considers the uncertainty of trip travel times and provides stop-skipping strategies which are robust to travel-time variations. In more detail, we show how historical travel-time observations can be integrated into a Genetic Algorithm (GA) that tries to compute a robust stop-skipping strategy for all daily trips of a bus line. The proposed mathematical program of robust stop-skipping at the tactical planning stage is solved using the minimax principle, whereas the GA implementation ensures that improved solutions can be obtained even for high-dimensional problems by avoiding the exhaustive exploration of the solution space. The proposed approach is validated with the use of five months of data from a circular bus line in Singapore demonstrating an improved performance of more than 10% in worst-case scenarios which encourages further investigation of the robust stop-skipping strategy.

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