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AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients.

Ray N, Ebener S - Int J Health Geogr (2008)

Bottom Line: Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available.By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities.This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Information, Evidence and Research, World Health Organization, 20 av, Appia, 1211 Geneva 27, Switzerland. nicolas.ray@zoo.unibe.ch

ABSTRACT

Background: Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network.

Results: This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.x, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage.

Conclusion: By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations.

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Outputs of the scaling-up analysis. Results show locations and corresponding catchment areas of five new health facilities based on a maximum travelling time of 90 minutes.
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Figure 7: Outputs of the scaling-up analysis. Results show locations and corresponding catchment areas of five new health facilities based on a maximum travelling time of 90 minutes.

Mentions: One of the results of the previous analysis is a population density grid showing the unserved population by the health facility network and the transportation scenario considered. This grid can be used in a subsequent scaling-up analysis, whose aim is to target optimized locations for new health facilities. In AccessMod, these optimized locations are cells with the largest unserved population, because it is considered to be more cost effective to prioritize these areas. We show in Figure 7 an example of such scaling-up exercise targeting five new health facilities with a maximum travelling time of 90 minutes. The base population density grid for this analysis was the one obtained after application of the analysis of the existing network under transportation scenario 2 (car + walking). Moreover, we considered an area unsuitable for new health facilities and that is located around the major southern wetland area. Note that AccessMod automatically integrates this unsuitable area in the analysis, but appropriately considers the population within this area to be reachable and accounted for by the catchment area of the new health facilities.


AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients.

Ray N, Ebener S - Int J Health Geogr (2008)

Outputs of the scaling-up analysis. Results show locations and corresponding catchment areas of five new health facilities based on a maximum travelling time of 90 minutes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651127&req=5

Figure 7: Outputs of the scaling-up analysis. Results show locations and corresponding catchment areas of five new health facilities based on a maximum travelling time of 90 minutes.
Mentions: One of the results of the previous analysis is a population density grid showing the unserved population by the health facility network and the transportation scenario considered. This grid can be used in a subsequent scaling-up analysis, whose aim is to target optimized locations for new health facilities. In AccessMod, these optimized locations are cells with the largest unserved population, because it is considered to be more cost effective to prioritize these areas. We show in Figure 7 an example of such scaling-up exercise targeting five new health facilities with a maximum travelling time of 90 minutes. The base population density grid for this analysis was the one obtained after application of the analysis of the existing network under transportation scenario 2 (car + walking). Moreover, we considered an area unsuitable for new health facilities and that is located around the major southern wetland area. Note that AccessMod automatically integrates this unsuitable area in the analysis, but appropriately considers the population within this area to be reachable and accounted for by the catchment area of the new health facilities.

Bottom Line: Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available.By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities.This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Information, Evidence and Research, World Health Organization, 20 av, Appia, 1211 Geneva 27, Switzerland. nicolas.ray@zoo.unibe.ch

ABSTRACT

Background: Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network.

Results: This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.x, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage.

Conclusion: By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations.

Show MeSH
Related in: MedlinePlus