scholarly journals Multi-Mode Two-Step Floating Catchment Area (2SFCA) Method to Measure the Potential Spatial Accessibility of Healthcare Services

2019 ◽  
Vol 8 (5) ◽  
pp. 236 ◽  
Author(s):  
Jianhua Ni ◽  
Ming Liang ◽  
Yan Lin ◽  
Yanlan Wu ◽  
Chen Wang
Keyword(s):  
Travel Behavior ◽  
Urban Areas ◽  
Catchment Area ◽  
Methodological Approach ◽  
Open Data ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
Urban Residents ◽  
Transportation Modes ◽  
Multi Mode

While great progress in the development of a methodological approach to measure the accessibility of healthcare services has been made, the exclusion of the complex multi-mode travel behavior of urban residents and a rough calculation of travel costs from the origin to the destination limit its potential for making a detailed assessment, especially in urban areas. In this paper, we aim to describe and implement an enhanced method that enables the integration of multiple transportation modes into a two-step floating catchment area (2SFCA) method to estimate accessibility. We used a travel-mode choice survey, based on distance sections, to determine the complex multi-mode travel behavior of urban residents. Taking Nanjing as a study area, we proposed complete door-to-door approaches to determine every aspect of basic transportation modes. Additionally, we processed open data to implement an accurate computing of the origin-destination (OD) time cost. We applied the enhanced method to estimate the accessibility of residents to hospitals and compared it with three single-mode 2SFCA methods. The results showed that the proposed method effectively identified more accessibility details and provided more realistic accessibility values.

scholarly journals A Spatial Ecosystem Services Assessment to Support Decision and Policy Making: The Case of the City of Bologna

2021 ◽  
Vol 13 (5) ◽  
pp. 2787
Author(s):  
Francesca Vignoli ◽  
Claudia de Luca ◽  
Simona Tondelli
Keyword(s):  
Ecosystem Services ◽  
Urban Areas ◽  
Methodological Approach ◽  
Supply And Demand ◽  
Rapid Assessment ◽  
Open Data ◽  
Canopy Cover ◽  
Tree Canopy ◽  
Tree Canopy Cover ◽  
The City

In recent years, both mapping and assessing urban Ecosystem Services (ESs) to support urban planning has been a topic of great debate. This work aims at contributing to this discussion by developing and testing a methodological approach to first assess and map supply and demand of ESs, and then identify areas of priority of intervention. Starting from the existing models, the work develops a tailored approach to map and assess three ESs (water retention and runoff, PM10 removal, and carbon sequestration and storage) that are tested in the city of Bologna and tailored according to available open data. All data are processed in a GIS environment to allow for spatial distribution and visualization of ESs. These maps facilitate defining supply and demands and, consequently, the presence and distribution of ESs deficiencies. Building on mismatches, this paper proposes four clusters by grouping the city’s districts based on predominant land use (built-up, green urban areas) and tree canopy cover. This classification enabled the identification of intervention priority areas and suggestions of relevant nature-based solutions (NBS) to be implemented. The proposed method can serve other urban areas to perform a rapid assessment of their current needs and challenges in terms of ES provision.

Modelling the spatial accessibility of the elderly to healthcare services in Beijing, China

2018 ◽  
Vol 46 (6) ◽  
pp. 1132-1147 ◽  
Author(s):  
Zhuolin Tao ◽  
Yang Cheng
Keyword(s):  
Public Transportation ◽  
Population Aging ◽  
The Elderly ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
The Public ◽  
Proposed Model ◽  
Peripheral Areas ◽  
Beijing China ◽  
Multi Mode

In the context of rapid population aging, Beijing is facing great challenges in providing healthcare services for the elderly. The objective of this study is to measure the spatial accessibility of the elderly to healthcare services in Beijing. A major challenge is that healthcare services are not exclusive for the elderly, so the elderly must compete with the non-elderly for access to healthcare services. In this study, we have developed a multi-mode and variable-demand two-step floating catchment area model for measuring spatial accessibility of the elderly to healthcare services, taking into account the competition between the elderly and non-elderly. This is modeled by differences in demand intensity and mobility. The elderly have a higher demand intensity and are disadvantaged in mobility due to their higher dependence on public transportation than the non-elderly. To improve the elderly’s healthcare accessibility, more healthcare resources should be allocated and the public transportation to hospitals should be improved, especially in peripheral areas. The proposed model can also be applied in other scenarios considering multiple population groups with different demand intensity for public services and mobility.

scholarly journals Geographic access to COVID-19 healthcare in Brazil using a balanced float catchment area approach

2020 ◽  
Author(s):  
Rafael H. M. Pereira ◽  
Carlos Kaue Vieira Braga ◽  
Luciana Mendes Servo ◽  
Bernardo Serra ◽  
Pedro Amaral ◽  
...  
Keyword(s):  
Urban Areas ◽  
Catchment Area ◽  
Local Level ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Access To Health Services ◽  
Mechanical Ventilators ◽  
Healthcare Facilities ◽  
Geographic Access ◽  
Spatial Inequalities

The rapid spread of the new coronavirus across the world has raised concerns about the responsiveness of cities and healthcare systems during pandemics. Recent studies try to model how the number of COVID-19 infections will likely grow and impact the demand for hospitalization services at national and regional levels. However, less attention has been paid to the geographic access to COVID-19 healthcare services and to the response capacity of hospitals at the local level, particularly in urban areas in the Global South. This paper shows how transport accessibility analysis can provide actionable information to help improve healthcare coverage and responsiveness. It analyzes accessibility to COVID-19 healthcare at high spatial resolution in the 20 largest cities of Brazil. Using network-distance metrics, we estimate the vulnerable population living in areas with poor access to healthcare facilities that could either screen or hospitalize COVID-19 patients. We then use a new balanced floating catchment area (BFCA) indicator to estimate spatial, income and racial inequalities in access to hospitals with intensive care unit (ICU) beds and mechanical ventilators while taking into account congestion effects. Based on this analysis, we identify substantial social and spatial inequalities in access to health services during the pandemic. The availability of ICU equipment varies considerably between cities and it is substantially lower among black and poor communities. The study maps territorial inequalities in healthcare access and reflects on different policy lessons that can be learned for other countries based on the Brazilian case.

scholarly journals Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dantong Zhao ◽  
Zhongliang Zhou ◽  
Chi Shen ◽  
Rashed Nawaz ◽  
Dan Li ◽  
...  
Keyword(s):  
Patient Experience ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Healthcare Services ◽  
Urban Residents ◽  
Exact Matching ◽  
Rural Residents ◽  
Healthcare Resources ◽  
Coarsened Exact Matching ◽  
Rural And Urban

Abstract Background Patient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban differences in patient experience in China. Methods Data regarding this study were drawn from Chinese General Social Survey (CGSS) 2015, with a sample size of 9604. Patient experience was measured by the evaluation on healthcare services. Coarsened exact matching (CEM) method was used to balance covariates between the rural and urban respondents. Three thousand three hundred seventy-two participants finally comprised the matched cohort, including 1592 rural residents and 1780 urban residents. Rural and urban differences in patient experience were tested by ordinary least-squares regression and ordered logistic regression. Results The mean (SD) score of patient experience for rural and urban residents was 72.35(17.32) and 69.45(17.00), respectively. Urban residents reported worse patient experience than rural counterparts (Crude analysis: Coef. = − 2.897, 95%CI: − 4.434, − 1.361; OR = 0.706, 95%CI: 0.595, 0.838; Multivariate analysis: Coef. = − 3.040, 95%CI: − 4.473, − 1.607; OR = 0.675, 95%CI: 0.569, 0.801). Older (Coef. = 2.029, 95%CI: 0.338, 3.719) and healthier (Coef. = 2.287, 95%CI: 0.729, 3.845; OR = 1.217, 95%CI: 1.008, 1.469) rural residents living in western area (Coef. = 2.098, 95%CI: 0.464, 3.732; OR = 1.276, 95%CI: 1.044, 1.560) with higher social status (Coef. = 1.158, 95%CI: 0.756, 1.561; OR = 1.145, 95%CI: 1.090, 1.204), evaluation on adequacy (Coef. = 7.018, 95%CI: 5.045, 8.992; OR = 2.163, 95%CI: 1.719, 2.721), distribution (Coef. = 4.464, 95%CI: 2.471, 6.456; OR = 1.658, 95%CI: 1.312, 2.096) and accessibility (Coef. = 2.995, 95%CI: 0.963, 5.026; OR = 1.525, 95%CI: 1.217, 1.911) of healthcare resources had better patient experience. In addition, urban peers with lower education (OR = 0.763, 95%CI: 0.625, 0.931) and higher family economic status (Coef. = 2.990, 95%CI: 0.959, 5.021; OR = 1.371, 95%CI: 1.090,1.723) reported better patient experience. Conclusions Differences in patient experience for rural and urban residents were observed in this study. It is necessary to not only encourage residents to form a habit of seeking healthcare services in local primary healthcare institutions first and then go to large hospitals in urban areas when necessary, but also endeavor to reduce the disparity of healthcare resources between rural and urban areas by improving quality and capacity of rural healthcare institutions and primary healthcare system of China.

scholarly journals Exploring Equity in Healthcare Services: Spatial Accessibility Changes during Subway Expansion

2021 ◽  
Vol 10 (7) ◽  
pp. 439
Author(s):  
Maohua Liu ◽  
Siqi Luo ◽  
Xishihui Du
Keyword(s):  
Public Transport ◽  
Urban Areas ◽  
Supply And Demand ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
Walking Distance ◽  
Theil Index ◽  
Special Focus ◽  
Transport Services ◽  
Healthcare Accessibility

The unequal allocation of healthcare resources raises many fundamental problems, one of which is how to address inequity in population health. This paper focuses on disparities in public transport healthcare accessibility, with a special focus on an expanding subway system. Based on a vulnerability index, including factors that are likely to limit healthcare opportunities, a two-step floating catchment area method was used to assess the distribution of supply and demand for healthcare. Quantity, quality, and walking distance accessibility were aggregated into hexagonal grids. The Theil index was used to measure inequity and understand the influence of subways on spatial disparities in healthcare accessibility. The ongoing construction of the subway has heterogeneous impacts on healthcare accessibility for different parts of the city and exacerbates spatial inequity in many areas. In an environment where people in peri-urban areas are excluded from healthcare access because of low subway coverage, the results suggest that the potential for subways to address inaccessibility is limited. The findings highlight the requirement of efficient public transport services and are relevant to researchers, planners, and policymakers aiming to improve accessibility to healthcare, especially for populations who dwell in winter cities.

scholarly journals Presentation, Management, and Outcomes across the Rural-Urban Continuum for Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Kali Zhou ◽  
Trevor A Pickering ◽  
Christina S Gainey ◽  
Myles Cockburn ◽  
Mariana C Stern ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Rural Communities ◽  
Urban Areas ◽  
Tumor Stage ◽  
The United States ◽  
Population Based ◽  
Urban Residents ◽  
Place Of Residence ◽  
Incidence And Mortality ◽  
Receive Treatment

Abstract Background Hepatocellular carcinoma is one of few cancers with rising incidence and mortality in the United States. Little is known about disease presentation and outcomes across the rural-urban continuum. Methods Using the population-based SEER registry, we identified adults with incident hepatocellular carcinoma between 2000–2016. Urban, suburban and rural residence at time of cancer diagnosis were categorized by the Census Bureau’s percent of the population living in non-urban areas. We examined association between place of residence and overall survival. Secondary outcomes were late tumor stage and receipt of therapy. Results Of 83,368 cases, 75.8%, 20.4%, and 3.8% lived in urban, suburban, and rural communities, respectively. Median survival was 7 months (IQR 2–24). All stage and stage-specific survival differed by place of residence, except for distant stage. In adjusted models, rural and suburban residents had a respective 1.09-fold (95% CI = 1.04–1.14, p < .001) and 1.08-fold (95% CI = 1.05–1.10, p < .001) increased hazard of overall mortality as compared to urban residents. Furthermore, rural and suburban residents had 18% (OR = 1.18, 95% CI 1.10–1.27, p < .001) and 5% (OR = 1.05, 95% CI = 1.02–1.09, p = .003) higher odds of diagnosis at late stage and were 12% (OR = 0.88, 95% CI = 0.80–0.94, p < .001) and 8% (OR = 0.92, 95% CI = 0.88–0.95, p < .001) less likely to receive treatment, respectively, compared to urban residents. Conclusions Residence in a suburban and rural community at time of diagnosis was independently associated with worse indicators across the cancer continuum for liver cancer. Further research is needed to elucidate the primary drivers of these rural-urban disparities.

scholarly journals Understanding policing demand and deployment through the lens of the city and with the application of big data

Urban Studies ◽  
2021 ◽  
pp. 004209802098100
Author(s):  
Mark Ellison ◽  
Jon Bannister ◽  
Won Do Lee ◽  
Muhammad Salman Haleem
Keyword(s):  
Big Data ◽  
Urban Environment ◽  
Urban Areas ◽  
Multilevel Model ◽  
Open Data ◽  
Front Line ◽  
Criminological Research ◽  
The Social ◽  
Generalised Method Of Moments ◽  
The City

The effective, efficient and equitable policing of urban areas rests on an appreciation of the qualities and scale of, as well as the factors shaping, demand. It also requires an appreciation of the factors shaping the resources deployed in their address. To this end, this article probes the extent to which policing demand (crime, anti-social behaviour, public safety and welfare) and deployment (front-line resource) are similarly conditioned by the social and physical urban environment, and by incident complexity. The prospect of exploring policing demand, deployment and their interplay is opened through the utilisation of big data and artificial intelligence and their integration with administrative and open data sources in a generalised method of moments (GMM) multilevel model. The research finds that policing demand and deployment hold varying and time-sensitive association with features of the urban environment. Moreover, we find that the complexities embedded in policing demands serve to shape both the cumulative and marginal resources expended in their address. Beyond their substantive policy relevance, these findings serve to open new avenues for urban criminological research centred on the consideration of the interplay between policing demand and deployment.

A systematic review of mobile health interventions in China: Identifying gaps in care

2019 ◽  
pp. 1357633X1985674 ◽  
Author(s):  
Xiaoshi Yang ◽  
Carrie L Kovarik
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Mobile Health ◽  
Urban Areas ◽  
Healthcare Services ◽  
Text Messages ◽  
Health Interventions ◽  
Health System Strengthening ◽  
World Health ◽  
Common Disease

Introduction Mobile health has a promising future in the healthcare system in most developed countries. China’s rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions. Methods A systematic review of the literature published from 18 December 2015–3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes. Results A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations. Conclusions Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.

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