Spatial accessibility in suboptimally configured health care systems: A modified two-step floating catchment area (M2SFCA) metric

被引：221

作者：

Delamater, Paul L. ^{[1
]}

机构：

[1] Michigan State Univ, Dept Geog, E Lansing, MI 48824 USA

来源：

HEALTH & PLACE | 2013年 / 24卷

关键词：

E2SFCA; 3SECA; Spatial accessibility; Gravity models; Health care access; ACCESS;

D O I：

10.1016/j.healthplace.2013.07.012

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

The floating catchment area (FCA) family of metrics employ principles from gravity-based models to incorporate supply, demand, and distance in their characterization of the spatial accessibility of health care resources. Unlike traditional gravity models, the FCA metrics provide an output in highly interpretable container-like units (e g, physicians per person). This work explores two significant issues related to FCA metrics. First, the Three Step Floating Catchment Area is critically examined. Next, the research shows that all FCA metrics contain an underlying assumption that supply locations are optimally configured to meet the needs of the population within the system. Because truly optimal configurations are highly unlikely in real-world health care systems, a modified two-step floating catchment area (M2SFCA) metric is offered to address this issue. The M2SFCA is built upon previous FCA metrics, but allows for spatial accessibility to be discounted as a result of the suboptimal configuration of health care facilities within the system. The utility of the new metric is demonstrated through simulated data examples and a case study exploring acute care hospitals in Michigan. (C) 2013 Elsevier Ltd. All rights reserved

引用

页码：30 / 43

页数：14

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