A Mathematical Model for Deriving Hospital Service Areas

1974 ◽  
Vol 4 (2) ◽  
pp. 353-364 ◽  
Author(s):  
James Meade

The basic premise explored in this paper is that patient flow in rural areas is based on the proximity to medical care. The hospital is defined as the center of care and hospital catchment areas are defined by patient movements. A methodology is described to analyze patient flow among an assemblage of hospitals. Finally, a model which mathematically replicates patient movement is introduced to act as an aid in the hospital planning process.

Author(s):  
Yuliya M. Beglyakova ◽  
◽  
Aleksander S. Shchirskii ◽  

The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.


2021 ◽  
pp. 001955612110016
Author(s):  
Anurima Mukherjee Basu ◽  
Rutool Sharma

Current urbanisation trends in India show a quantum jump in number of ‘census towns’, which are not statutorily declared as urban areas, but have acquired all characteristics of urban settlements. Sizeable number of such census towns are not located near any Class 1 city. Lack of proper and timely planning has led to unplanned growth of these settlements. This article is based on a review of planning legislations, institutional framework and planning process of four states in India. The present article analyses the scope and limitations of the planning process adopted in the rapidly urbanising rural areas of these states. The findings reveal that states are still following a conventional approach to planning that treats ‘urban’ and ‘rural’ as separate categories and highlights the need for adopting an integrated territorial approach to planning of settlements.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julianna M. Dean ◽  
Kimberly Hreha ◽  
Ickpyo Hong ◽  
Chih-Ying Li ◽  
Daniel Jupiter ◽  
...  

Abstract Background Despite the success of stroke rehabilitation services, differences in service utilization exist. Some patients with stroke may travel across regions to receive necessary care prescribed by their physician. It is unknown how availability and combinations of post-acute care facilities in local healthcare markets influence use patterns. We present the distribution of skilled nursing, inpatient rehabilitation, and long-term care hospital services across Hospital Service Areas among a national stroke cohort, and we describe drivers of post-acute care service use. Methods We extracted data from 2013 to 2014 of a national stroke cohort using Medicare beneficiaries (174,498 total records across 3232 Hospital Service Areas). Patients’ ZIP code of residence was linked to the facility ZIP code where care was received. If the patient did not live in the Hospital Service Area where they received care, they were considered a “traveler”. We performed multivariable logistic regression to regress traveling status on the care combinations available where the patient lived. Results Although 73.4% of all Hospital Service Areas were skilled nursing-only, only 23.5% of all patients received care in skilled nursing-only Hospital Service Areas; 40.8% of all patients received care in Hospital Service Areas with only inpatient rehabilitation and skilled nursing, which represented only 18.2% of all Hospital Service Areas. Thirty-five percent of patients traveled to a different Hospital Service Area from where they lived. Regarding “travelers,” for those living in a skilled nursing-only Hospital Service Area, 49.9% traveled for care to Hospital Service Areas with only inpatient rehabilitation and skilled nursing. Patients living in skilled nursing-only Hospital Service Areas had more than five times higher odds of traveling compared to those living in Hospital Service Areas with all three facilities. Conclusions Geographically, the vast majority of Hospital Service Areas in the United States that provided rehabilitation services for stroke survivors were skilled nursing-only. However, only about one-third lived in skilled nursing-only Hospital Service Areas; over 35% traveled to receive care. Geographic variation exists in post-acute care; this study provides a foundation to better quantify its drivers. This study presents previously undescribed drivers of variation in post-acute care service utilization among Medicare beneficiaries—the “traveler effect”.


Author(s):  
К. А. Галкин

Ситуация пандемии COVID-19 в очередной раз напомнила о необходимости использования онлайн-сообществ здоровья, особенно в тех районах, где не хватает мест в местных больницах или существуют проблемы с получением качественной медицинской помощи. Это, например, сельские районы, где медицина ориентирована на лечение экстренно возникающих заболеваний и у врачей существуют сложности с возможностью лечения новой коронавирусной инфекции. Онлайн-сообщества здоровья в таком случае предоставляют возможность узнать необходимую информацию, а также общаться со специалистами, которые знают особенности нового коронавируса и могут дать необходимые советы. В настоящей статье на примере глубинных интервью с пожилыми людьми из сёл Ленинградской обл. и Республики Карелия рассмотрена роль телемедицины для пожилых людей и общения в онлайн-сообществах здоровья в контексте преодоления одиночества и изолированности, которая существует в сельской местности. В статье проанализированы особенности и основные препятствия для использования пожилыми людьми телемедицины и общения в онлайнсообществах здоровья - это проблемы с инфраструктурой и отключением электричества, отсутствие у пожилых людей компьютерной грамотности для общения и взаимодействия в онлайн-сообществах здоровья. Роль последних рассмотрена с точки зрения развития самозаботы пожилых людей в сельской местности в периферийных поселениях из-за отсутствия необходимой медицинской помощи. The situation of the COVID-19 pandemic has once again reminded of the need to use telemedicine and online health communities, especially in areas where there are not enough places in local hospitals or there are problems with obtaining quality medical care, such as rural areas where rural medicine is focused on treatment of emergency diseases and doctors have difficulties with the possibility of treatment, as well as explaining about the new coronavirus infection to patients and how this disease can be treated. In this case, online health communities provide an opportunity to find out the necessary information, as well as communicate with specialists who know the features of the new coronavirus and can give the necessary advice. Using the example of in-depth interviews with older people from villages in the Leningrad Region and the Republic of Karelia, the article examines the role of telemedicine for older people and communication in online health communities in the context of overcoming loneliness and isolation that exist in rural areas. The article analyzes the features of the use of telemedicine and the key barriers to the use of telemedicine and communication of older people in online disease communities. In rural areas the main barriers to telemedicine use are infrastructure problems and power outages, as well as the lack of computer literacy for communication and elder people’s interaction in online health communities. In the article the role of online health communities is considered in the context of the self-care of older people and from the point of view of the development of self-care of older people in rural peripheral settlements due to the lack of necessary medical care.


2011 ◽  
Vol 31 (5) ◽  
pp. 1015-1026
Author(s):  
Julio C. Molina ◽  
Carlito Calil Júnior ◽  
Roberto R. de Freitas

In São Paulo State, mainly in rural areas, the utilization of wooden poles is observed for different purposes. In this context, wood in contact with the ground presents faster deterioration, which is generally associated to environmental factors and, especially to the presence of fungi and insects. With the use of mathematical models, the useful life of wooden structures can be predicted by obtaining "climatic indexes" to indicate, comparatively among the areas studied, which have more or less tendency to fungi and insects attacks. In this work, by using climatological data of several cities at São Paulo State, a simplified mathematical model was obtained to measure the aggressiveness of the wood in contact with the soil.


1972 ◽  
Vol 2 (2) ◽  
pp. 239-242
Author(s):  
J. Fry

The health services of the U.S.S.R. are organized and administered on a master plan based on central and monolithic planning according to Marxist socioeconomic principles. The health services have provided good available and accessible medical care to all its peoples. This has been a great and remarkable achievement. Primary medical services in the U.S.S.R. are provided by a series of specialists— uchastok (neighborhood) pediatricians, therapists (internists), occupational physicians, and dentists. Each has an allocated geographic locality and there is no free choice of physician. The uchastok physicians work from polyclinics with specialists. They also carry out daily home visits. There are no hospital facilities. The nature of the work and the work load is similar to that of primary physicians in other systems. In rural areas because of dispersal of populations, primary medical care is carried out by medical assistants (feldshers) who work under the supervision of physicians.


PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 388-388
Author(s):  
D. Morley

Although three quarters of the population in most developing countries live in rural areas, three quarters of the spending on medical care is in urban areas, where three quarters of the doctors live. Three quarters of the deaths are caused by conditions that can be prevented at low cost, but three quarters of the medical budget is spent on curative services, many of them provided for the elite at high cost.


Author(s):  
Constance J. Doyle ◽  
Richard E. Birney

Many disaster plans are based on the presence of a physician at the scene to perform triage. This requirement originated when there were no trained paramedical personnel in the field and may actually delay care in rural areas where a physician may not be readily available or may be the only physician at the hospital.It is our hypothesis that properly trained Advanced Emergency Medical Technicians (AEMT's) may serve as triage officers for rural disasters with little difference, and perhaps improvement, in the outcomes of medical care. AEMT's are among the first responders to arrive at scenes of accidents and often triage from three to five trauma patients in multiple victim accidents on the highway. They are on duty, available and strategically located both day and night. The AEMT's are familiar with working under field conditions, i.e. at night by headlight, in rain, snow, and darkness, and know extrication procedures. They are aware of environmental hazards. They have radio and telemetry communication with a physician when needed.


2019 ◽  
Vol 218 (2) ◽  
pp. 281-287 ◽  
Author(s):  
Sreeya S. Komaravolu ◽  
Julia J. Kim ◽  
Supreet Singh ◽  
Aziz M. Merchant

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