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Public policy implication Medical Geography: Health Care Accessibility and Implications Fahui Wang Fred B. Kniffen Professor of Geography Louisiana State University June 17, 2010 @ CNU Contents The issue of access GIS-based accessibility measures Optimization towards equal access Application in healthcare access PHSA designation and late-stage cancer Concluding comments Access Matters! Convenience of access to activities job, school, healthcare, park, public service, shopping … Access defines “location” Spatial Where you are Nonspatial Who you are Social justice and public policy Measurement How scarce are the services? Supply vs. Demand (ratio) How far are demands from supplies? Distance Road network Transportation means Primitive measures Distance (time) from supply Simply potential model Supply-demand ratio within an area FCA with a radius/box FCA with a travel time range From S/D Ratio to FCA Simply S/D Ratio FCA with a Radius Improvements Within-unit variation Cross-border Limitations Straight-line S-D beyond radius 2-step floating catchment area: 2SFCA Scale availability at each supply location Sum up accessible supplies around each demand location 2SFCA Recap 1a. For each supply location j, select all demand locations k within a travel time range from j (catchment Cj). 1b. Compute the supply to demand ratio within Cj: 2a. For each demand location i, search all supply locations j within the travel time range from i (catchment Zi). 2b. Sum up the supply to demand ratios at these supply locations: Generalizing “distance decay” as a continuous function a power or exponential function a Gaussian function as a discrete variable dichotomous as in 2SFCA multiple as in E2SFCA a hybrid approach a kernel density function a three-zone approach Generalizing “distance decay” Validation Modeling actual supply-demand interactions Individual travel behavior Aggregated travel pattern Optimization Towards equal accessibility Formulated as a planning probl