Spatial accessibility in suboptimally configured health care systems: A modified two-step floating catchment area (M2SFCA) metric
Spatial accessibility in suboptimally configured health care systems: A modified two-step floating catchment area (M2SFCA) metric
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DOI：
10.1016/j.healthplace.2013.07.012
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发表时间：
2013-11-01
期刊：
影响因子：
4.8
通讯作者：
Delamater, Paul L.
中科院分区：
文献类型：
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作者：
Delamater, Paul L.
浮动集水区（FCA）系列指标采用基于重力的模型的原则，将供应，需求和距离纳入其对医疗保健资源空间可及性的表征。与传统的重力模型不同，FCA指标以高度可解释的容器式单位（例如，每人的医生）提供输出。这项工作探讨了与FCA指标相关的两个重要问题。首先，三步浮动集水区进行了严格审查。接下来，研究表明，所有FCA指标都包含一个基本假设，即供应地点的配置最佳，以满足系统内人口的需求。由于真正的最佳配置是极不可能在现实世界的医疗保健系统，一个修改后的两步浮动集水区（M2SFCA）的指标来解决这个问题。M2SFCA建立在以前的FCA指标基础上，但由于系统内医疗保健设施的次优配置，允许空间可达性打折扣。通过模拟数据示例和密歇根州急性护理医院的案例研究，证明了新指标的实用性。(C)2013爱思唯尔有限公司版权所有
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