scholarly journals Analysis of Spatial Accessibility and Capacity of Multi-Level Healthcare Facilities in Greater Irbid Municipality, Jordan

Measuring the spatial accessibility and capacity of healthcare facilities is an important task to improve the quality of health services and reduce the pressure on them. This research assesses the current spatial accessibility and capacity of two-level of healthcare facilities (comprehensive healthcare centers and hospitals) in the Greater Irbid Municipality using the enhanced two-step floating catchment area (E2SFCA) method. To do this, Network analysis techniques including original-destination matrix (OD), service area, and location-allocation were employed for determining the travel time from residents' points towards every healthcare facility, the service coverage and capacity within travel time zones, and the number of served areas by every healthcare facility. Then, optimum locations for new healthcare facilities that improve the accessibility and capacity rates were determined. The results show that while all areas in the study area are located within a 30-minute drive from the hospital's locations, 18 out of 23 areas are within 15 minutes drive towards the comprehensive health centers. This means that 28.80% of the population needs more than 15 minutes of driving time to access the second level of healthcare services. In addition, the annual average of the actual patient-doctor ratio ranges from 1338 to 2900 patients per doctor in the hospitals, and 2676 to 8524 patients per doctor in the comprehensive healthcare centers, and thus, the health services are inadequate in the study area. Furthermore, the suggested new healthcare facilities in terms of the numbers and optimum location would improve the spatial accessibility and the capacity ratio.

2021 ◽  
pp. 11
Author(s):  
Muhamad Iqbal Januadi Putra ◽  
Nabila Dety Novia Utami

The presence of healthcare facilities is quite essential to provide good healthcare services in a particular area, however, the existence of healthcare facilities is not evenly distributed in Cianjur Regency. This condition leads to the disparities of healthcare facilities across the Cianjur Regency. In this paper, we aim to measure and map the spatial disparities of healthcare facilities using a Two-Step Floating Catchment Analysis (2SFCA). This method can calculate the magnitude of spatial accessibility for healthcare facilities by formulating the travel time threshold and the quality of healthcare facilities across the study area. This research shows the result that the spatial accessibility of healthcare facilities in the Cianjur Regency is not evenly distributed across the districts. The spatial accessibility value resulted from 2SFCA is ranging from 0- 3.97. A low value indicates low spatial accessibility, while a higher value shows good accessibility. The majority of districts in the Cianjur Regency have the spatial accessibility value 0-0.5 (86%). Meanwhile, only a few have the higher value; value 0.5-0.99 as much as 6.6%, 0.99-1.49 as 3.3%, and 3.48-3.97 has a percentage of 3.3%. Also, this analysis results in the cluster of good spatial accessibility in healthcare facilities, namely the Pagelaran District and Cipanas District. Interestingly, the downtown of Cianjur Regency has lower spatial accessibility compared to both areas.


Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  

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.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jialing Qiu ◽  
Duo Song ◽  
Juan Nie ◽  
Mengyi Su ◽  
Chun Hao ◽  
...  

Abstract Background The number of Chinese migrants in Sub-Saharan Africa (SSA) is increasing, which is part of the south-south migration. The healthcare seeking challenges for Chinese migrants in Africa are different from local people and other global migrants. The aim of this study is to explore utilization of local health services and barriers to health services access among Chinese migrants in Kenya. Methods Thirteen in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among Chinese migrants (n = 32) and healthcare-related stakeholders (n = 3) in Nairobi and Kisumu, Kenya. Data was collected, transcribed, translated, and analyzed for themes. Results Chinese migrants in Kenya preferred self-treatment by taking medicines from China. When ailments did not improve, they then sought care at clinics providing Traditional Chinese Medicine (TCM) or received treatment at Kenyan private healthcare facilities. Returning to China for care was also an option depending on the perceived severity of disease. The main supply-side barriers to local healthcare utilization by Chinese migrants were language and lack of health insurance. The main demand-side barriers included ignorance of available healthcare services and distrust of local medical care. Conclusions Providing information on quality healthcare services in Kenya, which includes Chinese language translation assistance, may improve utilization of local healthcare facilities by Chinese migrants in the country.


2020 ◽  
Author(s):  
Zahra Mohammadi Daniali ◽  
Mohammad Mehdi Sepehri ◽  
Farzad Movahedi Sobhani ◽  
Mohammad Heidarzadeh

Abstract BackgroundReducing neonatal mortality is one of the most important issue in developing countries. One powerful method to reduce the neonatal mortality rate is increase equity in access to health services by regionalization. This study employs national hospitalized birth data from march 2018 to march 2019 to determine the optimal number and location of Perinatal Care Services (PCS) and to manage the referral network of the region.MethodsThis research has examined effective criteria regarding PCS network design. These criteria include the equipment (number of Neonatal Intensive Care Unit (NICU) and ventilator), experts (number of neonatal expert and fellowship), gravity (actual journey of expectant mothers to hospitals), and the type of university manages hospital. Moreover, distances between demands and PCS were transformed into vehicular travel time according to the maximum speed limit in the country road network. There have been annual 315,992 hospitalized birth data. These data provided separately for each city and three types of service requirements according to the gestational age and birth weight, i.e., under 32 weeks or 1500 gram, between 32-34 weeks or 1500-2000 gram, and over 34 weeks or 2000 gram, which receive services of level I, II, and III, respectively. A model builder tool of ARC GIS software was applied to develop a three-level hierarchical location-allocation model to respond to the maximal demand in 30 (level I), 60 (level II), and 120 (level III) minuts of travel time. The developed model was then applied to serve neonates from uncovered cities. Moreover, the alternative PCS were determined for level III services to present more reliable solutions.ResultsObtained results revealed that the total 130, 121, and 86 PCS are needed to respond to demands of level I, II, III, respectively, in 373 different cities. The service level III has not covered 39 cities; hence another model assigned nearest PCS to these cities so that the travel distances from which to allocated centers were determined 173 min on average. ConclusionsRegionalization is an approach to increase spatial accessibility to health services. Finding the optimal location to implement PCS would gradually decrease neonatal mortality and morbidity. It can also reduce expenses of under-used local health centers and give better health care regarding the access to experts. In this way, regional services should be considered as a sustainable health care solution at the policy and decision-making levels of the region, national and universal healthcare network.


2016 ◽  
pp. 52-58
Author(s):  
Minh Tam Nguyen ◽  
Shimamura Yasuharu

Background: Patients often have their focus on looking for the high-quality healthcare services while minimizing costs in order to choose the healthcare facilities appropriate to their needs. Moreover, a double burden disease has led to changes in healthcare delivery model and health seeking behavior of patients. However, the relationship between such illness and the utilization of health care services has rarely been empirically assessed. Objective: To clarify how health status and symptoms associated with the healthcare facility choice. Methods: We conducted this survey in 3 provinces (Thua Thien Hue, Quang Tri, and Khanh Hoa), with 6,898 residents in 1,478 households. The International Classification of Primary Care (ICPC-2) was used to classify the symptoms. Results: There were 1,816 people having illness/injury during the last 3 months (26.3) and the majority of them went to CHCs when they got sick. Patients with digestive, neurological and respiratory symptoms were more likely to use CHCs as the first contact point. In contrast, people with musculoskeletal, female genital, and urological diseases were more likely to visit the higher level facilities such as provincial and central hospitals than CHCs. Key words: Healthcare sevices


Author(s):  
Liliana Dumitrache ◽  
Mariana Nae ◽  
Gabriel Simion ◽  
Ana-Maria Taloș

The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service from Google Maps and open data sources. Based on real-time traffic navigation data, we examined the potential accessibility of hospitals through a weighted model that took into account the hospital competency level and travel time while using personal car transportation mode. Two scenarios were generated that depend on hospitals’ level of competency (I–V). When considering all categories of hospitals, access is relatively good with over 80% of the population reaching hospitals in less than 30 min. This is much lower in the case of hospitals that provide complex care, with 34% of the population travelling between 90 to 120 min to the nearest hospital classed in the first or second category of competence. The index of spatial accessibility (ISA), calculated as a function of real travel time and level of competency of the hospitals, shows spatial patterns of services access that highlight regional disparities or critical areas. The high concentration of infrastructure and specialised medical personnel in particular regions and large cities limits the access of a large part of the population to quality health services with travel time and distances exceeding optimal European level values. The results can help decision-makers to optimise the location of health services and improve health care delivery.


2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Abdulkader Murad ◽  
Fazlay Faruque ◽  
Ammar Naji ◽  
Alok Tiwari

Considering spatial accessibility of health services is a critical part in the planning and management of health services. There is evidence that poor geographical locations can obstruct prompt basic health care services to some population sections. We developed a location-allocation P-median model for health centres after analysing their sites, demand location of health services and the road network in Jeddah, Saudi Arabia. This model attempts to optimize health care services network and to put forward location recommendations to maximise service coverage. Our model is shown to be useful as it provides a robust evidence base to urban planners and policymakers responsible for making spatial decisions for the development of the health sector. Besides, it follows the paradigm of new urbanism that encourages decentralisation of essential facilities including basic healthcare in cities, where emphasis is on offering all basic services within walkable distances of 15 min. or less.


2020 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  

Abstract Background: The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan. Method: Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level. Results: The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement. Conclusions: Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.


2019 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  

Abstract Background The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan.Method Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level.Results The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement.Conclusions Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.


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