Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Potential accessibility scores for hospital care in a province of Japan: GIS-based ecological study of the two-step floating catchment area method and the number of neighborhood hospitals

Authors: Takashi Nakamura, Akihisa Nakamura, Kengo Mukuda, Masanori Harada, Kazuhiko Kotani

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

For achieving equity of the accessibility to primary healthcare, measuring potential geographical accessibility is essential. The provider-to-population ratio is the most frequently used measure. However, it is difficult to be used in closer region because it does not take into consideration the people and health services beyond its boundary. In order to overcome this problem, we measured the potential access to hospital, using both distance measures and the enhanced two-step floating catchment area (E2SFCA) method. The aim of this study was to compare the number of hospitals in the neighborhood and the E2SFCA score with regard to the amount and equity for access to hospitals.

Methods

This descriptive study used publicly available data from 2010. The E2SFCA score and number of neighborhood hospitals were obtained from Tochigi province in Japan using a geographic information system. Dataset of four measures by each census tract was obtained. The measures were E2SFCA score, number of hospitals within the 5 km range, number of hospitals within the 10 km range, and number of hospitals within the 15 km range. Correlation and disparity analyses with the Lorenz curve and Gini coefficient were performed.

Results

The measures were obtained in a smaller area than municipality considering adjacent areas using a geographical approach. The E2SFCA score was 5.3 [3.2–7.3] hospitals/million (median [quantile range]), compared to 5.6 hospitals/million in total for the given district. The median number of hospitals within the 5 km, 10 km, and 15 km ranges were 1, 39, and 47, respectively. There was no hospital within the 5 km range in one third of the blocks. Both the number of hospitals within the 10 km range and those within the 15 km range were well correlated. Regional difference became smaller as the distance to count the number of hospitals increased. The gap between small number of hospitals and the high E2SFCA score indicated the location of community hospital in depopulated areas.

Conclusions

The E2SFCA method is superior for analyzing spatial access to hospital, because it provides information in the closer sub-regions. Regional differences were hardly seen in access to hospital beyond the 10 km range. Further studies in other regions and countries are needed for precise assessment.
Literature
1.
Love D, Lidquist P. The geographical accessibility of hospitals to the aged: a geographic information systems analysis within Illinois. Health Serv Res. 1995;29:629.PubMedPubMedCentral
2.
Jones AP, Bentham G, Horwell C. Health service accessibility and deaths from asthma. Int J Epidemiol. 1999;28:101.CrossRefPubMed
3.
Freitas PF, Drachler MdeL, Leite JC, et al. Inequalities in cesarean delivery rates by ethnicity and hospital accessibility in Brazil. Int J Gynaecol Obstet. 2009;107:198.
4.
Ansari Z. A review of literature on access to primary health care. Aust J Prim Health. 2007;13:80–95.CrossRef
5.
Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19:127–40.CrossRefPubMed
6.
Khan AA, Bhardwaj SM. Access to health care. A conceptual framework and its relevance to health care planning. Eval Health Prof. 1994;17:60–76.CrossRefPubMed
7.
8.
Cromley EK, McLafferty SL. GIS and public health 2nd edition. New York: The Guilford Press; 2012. p. 303–37.
9.
10.
Luo W, Wang F. Measures of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region. Environ Plann B. 2003;30:865–84.CrossRef
11.
12.
Luo W, Qi Y. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health Place. 2009;15:1100–7.CrossRefPubMed
13.
McGrail MR. Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements. Int J Health Geogr. 2012;11:50.CrossRefPubMedPubMedCentral
14.
Cheng Y, Wang J, Rosenberg MW. Spatial access to residential care resources in Beijing. China Int J Health Geogr. 2012;11:32.CrossRefPubMed
15.
Hu R, Dong S, Zhao Y, Hu H, Li Z. Assessing potential spatial accessibility of health services in rural China: a case study of Donghai county. Int J Equity Health. 2013;12:35.CrossRefPubMedPubMedCentral
16.
Luo W. Using a GIS-based floating catchment method to assess areas with shortage of physicians. Health Place. 2004;10:1–11.CrossRefPubMed
17.
18.
Ngui AN, Apparicio P. Optimizing the two-step floating catchment area method for measuring spatial accessibility to medical clinics in Montreal. BMC Health Serv Res. 2011;11:166.CrossRefPubMedPubMedCentral
19.
Scott J, Larson A, Jefferies F, Veenendaal B. Small-area estimates of general practice workforce shortage in rural and remote Western Australia. Aust J Rural Health. 2006;14:209–13.CrossRefPubMed
20.
McGrail MR, Humphreys JS. The index of rural access: an innovative integrated approach for measuring primary care access. BMC Health Serv Res. 2009;9:124.CrossRefPubMedPubMedCentral
21.
McGrail MR, Humphreys JS. Measuring spatial accessibility to primary care in rural areas: improving the effectiveness of the two-step floating catchment area method. Appl Geogr. 2009;29:533–41.CrossRef
22.
Vadrevu L, Kanjilal B. Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans. Int J Equity Health. 2016;15:87.CrossRefPubMedPubMedCentral
23.
Cervigni F, Suzuki Y, Ishii T, Hata A. Spatial accessibility to pediatric services. J Community Health. 2008;33:444–8.CrossRefPubMed
24.
Harada M, Okayama M, Ae R, Kojo T, Aihara M, Kajii E. A study on regional disparities in access to inpatient care, using the Gini coefficient. Gen Med. 2012;13:25–9.CrossRef
25.
Aoki M, Tomokiyo T. A study on the medical service area and the utility circle of the practitioner in the joint use type hospital. Trans Architectural Inst Jpn. 1983;332:111–7.
26.
Luo W, Whippo T. Variable catchment sizes for the two-step floating catchment area (2SFCA) method. Health Place. 2012;18:789–95.CrossRefPubMed
27.
Langford M, Higgs G, Fry R. Multi-modal two-step floating catchment area analysis of primary health care accessibility. Health Place. 2016;38:70–81.CrossRefPubMed
28.
Fransen K, Neutens T, De Maeyer P, Deruyter G. A commuter-based two-step floating catchment area method for measuring spatial accessibility of daycare centers. Health Place. 2015;32:65–73.CrossRefPubMed
29.
Wan N, Zou B, Sternberg T. A three-step floating catchment area method for analyzing spatial access to health services. Int J Geogr Inf Sci. 2012;26:1073–89.CrossRef
30.
Langford M, Fry R, Higgs G. Measuring transit system accessibility using a modified two-step floating catchment technique. Int J Geogr Inf Sci. 2012;26:193–214.CrossRef
31.
Delamater PL. Spatial accessibility in suboptimally configured health care systems: a modified two-step floating catchment area (M2SFCA) metric. Health Place. 2013;24:30–43.CrossRefPubMed
32.
Ni J, Wang J, Rui Y, Qian T, Wang J. An enhanced variable two-step floating catchment area method for measuring spatial accessibility to residential care facilities in Nanjing. Int J Environ Res Public Health. 2015;12:14490–504.CrossRefPubMedPubMedCentral
33.
Lin BC, Chen CW, Chen CC, Kuo CL, Fan IC, Ho CK, et al. Spatial decision on allocating automated external defibrillators (AED) in communities by multi-criterion two-step floating catchment area (MC2SFCA). Int J Health Geogr. 2016;15:17.CrossRefPubMedPubMedCentral
Metadata
Title
Potential accessibility scores for hospital care in a province of Japan: GIS-based ecological study of the two-step floating catchment area method and the number of neighborhood hospitals
Authors
Takashi Nakamura
Akihisa Nakamura
Kengo Mukuda
Masanori Harada
Kazuhiko Kotani
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2367-0

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue

Research article

Are physicians aware enough of patient radiation protection? Results from a survey among physicians of Pavia District– Italy

Research article

Educational level and 30-day outcomes after hospitalization for acute myocardial infarction in Italy

Research article

Threats to patient safety in primary care reported by older people with multimorbidity: baseline findings from a longitudinal qualitative study and implications for intervention

Debate

Moving towards a more inclusive patient and public involvement in health research paradigm: the incorporation of a trauma-informed intersectional analysis

Research article

Identifying gaps in the continuum of care for hypertension and diabetes in two Indian communities

Research article

Young people, mental health practitioners and researchers co-produce a Transition Preparation Programme to improve outcomes and experience for young people leaving Child and Adolescent Mental Health Services (CAMHS)