Does the edge effect impact on the measure of spatial accessibility to healthcare providers?
Does the edge effect impact on the measure of spatial accessibility to healthcare providers?
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DOI：
10.1186/s12942-017-0119-3
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发表时间：
2017-12-11
影响因子：
4.9
通讯作者：
Deguen S
中科院分区：
文献类型：
--
作者：
Gao F;Kihal W;Le Meur N;Souris M;Deguen S
在调查健康方面的不平等现象时，越来越多地采用空间可达性指数。尽管大多数研究都提到了边缘效应造成的潜在误差，但许多研究承认，在有限区域内建立空间分析时忽略了这一问题，而是假设设施的可达性将被低估。我们的研究旨在评估边缘对定义医疗服务提供者访问的准确性的影响，通过比较医疗服务提供者的可访问性会计或不为边缘效应，在现实世界中的应用。本研究在法国诺德省进行。我们使用的统计单位是法国国家统计和经济研究所定义的被称为“IRIS”的人口普查区。使用的地理可达性指标是基于E2SFCA算法的“空间可达性指数”。我们通过选择三种类型的医疗保健提供者来计算孕妇人群的伊萨：全科医生，妇科医生和助产士。比较了在考虑和不考虑边缘效应的情况下，城乡区域伊萨的变化。然后采用GIS方法确定全局和局部自相关。最后，我们比较了社会经济困境指数和伊萨之间的关系，在考虑或不考虑边缘效应，以充分评估其影响。结果表明，平均伊萨时，提供和需求超出边界时，包括略低于伊萨时，不考虑边缘效应，我们发现，IRIS值更有可能恶化比改善。此外，边缘效应的影响可能因医疗服务提供者的类型而有很大差异。农村IRIS组的变异性大于城市IRIS组。我们发现，社会经济困境变量和复合伊萨之间呈正相关。空间分析结果（如Moran的空间自相关指数和空间自相关的地方指标）并没有受到真正的影响。我们的研究揭示了轻微的可访问性变化时，边缘效应已被认为是在法国的背景下。由于影响的强度因医疗保健提供者类型、地区组织和用于衡量医疗保健可及性的方法而异，因此无法建立一般性声明。需要进行更多的研究，以区分哪些调查结果是某一地区特有的，哪些是不同国家共有的。这是一个有希望的方向，以更准确地确定医疗保健短缺领域，然后打击社会健康不平等。
Spatial accessibility indices are increasingly applied when investigating inequalities in health. Although most studies are making mentions of potential errors caused by the edge effect, many acknowledge having neglected to consider this concern by establishing spatial analyses within a finite region, settling for hypothesizing that accessibility to facilities will be under-reported. Our study seeks to assess the effect of edge on the accuracy of defining healthcare provider access by comparing healthcare provider accessibility accounting or not for the edge effect, in a real-world application. This study was carried out in the department of Nord, France. The statistical unit we use is the French census block known as ‘IRIS’ (Ilot Regroupé pour l’Information Statistique), defined by the National Institute of Statistics and Economic Studies. The geographical accessibility indicator used is the “Index of Spatial Accessibility” (ISA), based on the E2SFCA algorithm. We calculated ISA for the pregnant women population by selecting three types of healthcare providers: general practitioners, gynecologists and midwives. We compared ISA variation when accounting or not edge effect in urban and rural zones. The GIS method was then employed to determine global and local autocorrelation. Lastly, we compared the relationship between socioeconomic distress index and ISA, when accounting or not for the edge effect, to fully evaluate its impact. The results revealed that on average ISA when offer and demand beyond the boundary were included is slightly below ISA when not accounting for the edge effect, and we found that the IRIS value was more likely to deteriorate than improve. Moreover, edge effect impact can vary widely by health provider type. There is greater variability within the rural IRIS group than within the urban IRIS group. We found a positive correlation between socioeconomic distress variables and composite ISA. Spatial analysis results (such as Moran’s spatial autocorrelation index and local indicators of spatial autocorrelation) are not really impacted. Our research has revealed minor accessibility variation when edge effect has been considered in a French context. No general statement can be set up because intensity of impact varies according to healthcare provider type, territorial organization and methodology used to measure the accessibility to healthcare. Additional researches are required in order to distinguish what findings are specific to a territory and others common to different countries. It constitute a promising direction to determine more precisely healthcare shortage areas and then to fight against social health inequalities.
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影响因子：
4.8
作者：
Gao F;Kihal W;Le Meur N;Souris M;Deguen S
通讯作者：
Deguen S
影响因子：
4.8
作者：
Iredale, R;Jones, L;Deaville, J
通讯作者：
Deaville, J
影响因子：
4.9
作者：
Jordan, Hannah;Roderick, Paul;Barnett, Sarah
通讯作者：
Barnett, Sarah
DOI：
10.1068/a34171
发表时间：
2002-07-01
期刊：
ENVIRONMENT AND PLANNING A
影响因子：
--
作者：
Hewko, J;Smoyer-Tomic, KE;Hodgson, MJ
通讯作者：
Hodgson, MJ
影响因子：
3.6
作者：
ANSELIN, L
通讯作者：
ANSELIN, L