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http://dx.doi.org/10.4332/KJHPA.2016.26.2.233

Effects of Spatial Accessibility on the Number of Outpatient Visits for an Internal Medicine of a Hospital  

Lee, Eun-Joo (Big Data Steering Department, National Health Insurance Service)
Moon, Kyeong-Jun (Department of Health Administration, Yonsei University Graduate School)
Lee, Kwang-Soo (Department of Health Administration, Yonsei University College of Health Sciences)
Publication Information
Health Policy and Management / v.26, no.3, 2016 , pp. 233-241 More about this Journal
Abstract
Background: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. Methods: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level ($500{\times}500m$) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. Results: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. Conclusion: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.
Keywords
Spatial accessibility; Outpatient visit; Hot-spot analysis; Generalized linear model; Euclidean distance;
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1 Langford M, Higgs G. Measuring potential access to primary healthcare services: the influence of alternative spatial representations of population. Prof Geogr 2006;58(3):294-306. DOI: http://dx.doi.org/10.1111/j.1467-9272.2006.00569.x.   DOI
2 Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 1995;36(1):1-10. DOI: http://dx.doi.org/10.2307/2137284.   DOI
3 Guagliardo MF. Spatial accessibility of primary care: concepts, methods and challenges. Int J Health Geogr 2004;3(1):3.   DOI
4 Tanser F, Gijsbertsen B, Herbst K. Modelling and understanding primary health care accessibility and utilization in rural South Africa: an exploration using a geographical information system. Soc Sci Med 2006;63(3):691-705. DOI: http://dx.doi.org/10.1016/j.socscimed.2006.01.015.   DOI
5 Langford M, Higgs G. Accessibility and public service provision: evaluating the impacts of the Post Office Network Change Programme in the UK. Trans Inst Br Geogr 2010;35(4):585-601. DOI: http://dx.doi.org/10.1111/j.1475-5661.2010.00394.x.   DOI
6 Ingram DR, Clarke DR, Murdie RA. Distance and the decision to visit an emergency department. Soc Sci Med 1978;12(1D):55-62. DOI: http://dx.doi.org/10.1016/s0277-9536(79)80007-6.   DOI
7 Athas WF, Adams-Cameron M, Hunt WC, Amir-Fazli A, Key CR. Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery. J Natl Cancer Inst 2000;92(3):269-271. DOI: http://dx.doi.org/10.1093/jnci/92.3.269.   DOI
8 Nattinger AB, Kneusel RT, Hoffmann RG, Gilligan MA. Relationship of distance from a radiotherapy facility and initial breast cancer treatment. J Natl Cancer Inst 2001;93(17):1344-1346. DOI: http://dx.doi.org/10.1093/jnci/93.17.1344.   DOI
9 Lee YJ, Kim UJ. The effects of accessibility to medical facilities and public transportation on perceived health of urban and rural elderly: using generalized ordered logit model. J Korean Reg Dev Assoc 2015;27(1):65-88.
10 Schroen AT, Brenin DR, Kelly MD, Knaus WA, Slingluff CL Jr. Impact of patient distance to radiation therapy on mastectomy use in early-stage breast cancer patients. J Clin Oncol 2005;23(28):7074-7080. DOI: http://dx.doi.org/10.1200/jco.2005.06.032.   DOI
11 Kim KS. Household catastrophic health expenditure and unmet needs depending on the types of health care system. Soc Welf Policy 2012;39(4):255-279. DOI: http://dx.doi.org/10.15855/swp.2012.39.4.255.   DOI
12 Goodchild MF, Anselin L, Appelbaum RP, Harthorn BH. Toward spatially integrated social science. Int Reg Sci Rev 2000;23(2):139-159. DOI: http://dx.doi.org/10.1177/016001760002300201.   DOI
13 Kim HN. Regional disparity in the accessibility of public healthcare: focused on Seoul [dissertation]. Seoul: Seoul National University; 2014.
14 Kim SH. Analysis of geographic accessibility of the inpatients using GIS: case of a hospital in Kyeonggido [dissertation]. Seoul: Yonsei University; 2006.
15 Fortney J, Rost K, Warren J. Comparing alternative methods of measuring geographic access to health services. Health Serv Outcomes Res Methodol 2000;1(2):173-184.   DOI
16 Lovett A, Haynes R, Sunnenberg G, Gale S. Car travel time and accessibility by bus to general practitioner services: a study using patient registers and GIS. Soc Sci Med 2002;55(1):97-111. DOI: http://dx.doi.org/10.1016/s0277-9536(01)00212-x.   DOI
17 Henneman PL, Garb JL, Capraro GA, Li H, Smithline HA, Wait RB. Geography and travel distance impact emergency department visits. J Emerg Med 2011;40(3):333-339. DOI: http://dx.doi.org/10.1016/j.jemermed.2009.08.058.   DOI
18 Higgs G. A literature review of the use of GIS-based measures of access to health care services. Health Serv Outcomes Res Methodol 2004;5(2):119-139. DOI: http://dx.doi.org/10.1007/s10742-005-4304-7.   DOI
19 Hearnshaw HM, Unwin DJ. Visualization in geographical information systems. Chichester: John Wiley and Sons; 1994.
20 Kwan MP, Janelle DG, Goodchild MF. Accessibility in space and time: a theme in spatially integrated social science. J Geogr Sys 2003;5(1):1-3. DOI: http://dx.doi.org/10.1007/s101090300100.   DOI
21 Geronimus AT, Bound J, Neidert LJ. On the validity of using census geocode characteristics to proxy individual socioeconomic characteristics. J Am Stat Assoc 1996;91(434):529-537. DOI: http://dx.doi.org/10.1080/01621459.1996.10476918.   DOI
22 Aday LA, Andersen R. A framework for the study of access to medical care. Health Serv Res 1974;9(3):208-220.
23 Dutton D. Financial, organizational and professional factors affecting health care utilization. Soc Sci Med 1986;23(7):721-735. DOI: http://dx.doi.org/10.1016/0277-9536(86)90121-8.   DOI
24 Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci 2008;1136:161-171. DOI: http://dx.doi.org/10.1196/annals.1425.011.   DOI
25 Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18. DOI: http://dx.doi.org/10.1186/1475-9276-12-18.   DOI
26 Benjamin AE. Determinants of state variations in home health utilization and expenditures under Medicare. Med Care 1986;24(6):535-547. DOI: http://dx.doi.org/10.1097/00005650-198606000-00008.   DOI
27 Haynes RM. Geographical access to health care. In: Gulliford M, Morgan M, editors. Access to health care. London: Routledge; 2003. pp. 13-35.
28 Nho WH, Kim SB, Kang BS. Association of health-related behaviors with socio-demographic characteristics. J Agric Med Community Health 1998;23(2);157-174.
29 Salkever DS. Accessibility and the demand for preventive care. Soc Sci Med 1976;10(9-10):469-475. DOI: http://dx.doi.org/10.1016/0037-7856(76)90114-1.   DOI
30 Margolis PA, Carey T, Lannon CM, Earp JL, Leininger L. The rest of the access-to-care puzzle: addressing structural and personal barriers to health care for socially disadvantaged children. Arch Pediatr Adolesc Med 1995;149(5):541-545. DOI: http://dx.doi.org/10.1001/archpedi.1995.02170180071011.   DOI
31 Lee KS, Choi YJ. The effects of rival hospitals on the number of patients in a tertiary hospital. Korean Manag Sci Rev 2012;37(4):211-223. DOI: http://dx.doi.org/10.7737/jkorms.2012.37.4.211.
32 Lee KS, Lee JS. Spatial analysis modeling for the development of evaluating model for hospital location. Int J Contents 2009;9(10):258-267. DOI: http://dx.doi.org/10.5392/jkca.2009.9.10.258.
33 Kim DY. Spatial pattern analysis of forest fires using GIS: based on the nationwide forest fires data between 2000-2009. Geogr J Korea 2014;48(3):325-336.
34 Jeong EJ, Ahn JG, Jeon SY, Lee JY, Shim JY. Methods for the control of measured confounders in outcomes research. Seoul: National Evidence-based Healthcare Collaborating Agency; 2013.
35 Jo DH. Economic geography and GIS: a review of evaluation methods for spatial equity of public service distributions. Geogr Educ 2004;48:100-120.
36 Kim HS, Jeong DW. Characteristics of spatial distribution of medical services in Seoul. J Korean Urban Manag Assoc 2010;23(1):27-45.
37 Yu SM, Kim JS. A study on medical care utilization of public health center among beneficiaries of medical insurance. Korean Public Health Res 1996;45:21-34.
38 You CH, Kwon YD. Factors influencing medical institution selection for outpatient services. J Korean Med Assoc 2012;55(9):898-910. DOI: http://dx.doi.org/10.5124/jkma.2012.55.9.898.   DOI
39 Kim CM. Spatial distribution of patients on public health center [dissertation]. Seoul: Seoul National University; 2004.
40 Jeon KS, Choi ES, Lee HY. Gender-related difference in the utilization of health care services by Korean adults. J Korean Public Health Nurs 2010; 24(2):182-196.   DOI
41 Folland S, Goodman AC, Stano M. The economics of health and health care. 6th ed. Boston (MA): Prentice Hall; 1997.
42 Wilson P, Tedeschi P. Community correlates of hospital use. Health Serv Res 1984;19(3):333-355.
43 Lee KS, Lee JS, Hong SJ, Jeon BJ. Spatial implications of euclidean distance on the service use in oriental medicine hospital. Korean J Health Serv Manag 2010;4(2):23-31.
44 Park SK, Lee SH, Cung AR, Jwa YG, Myung HB, Na BJ. A study on medical service area setting about medical using and supply. Cheongju: Korea Health Industry Development Institute; 2011.
45 Cho WH, Kim HJ, Lee SH. A study on the criteria for selection of medical care facilities. Korean J Prev Med 1992;25(1):53-63.
46 So KS. A study on the relationship between the hospital location and the number of patients: focused on Seoul [dissertation]. Daejeon: Konyang University; 2001.