Abstract
A theoretical model was developed using the entropy approach to cope with the random component of the utility function to find that the spatial accessibility improves as the provider capacity increases or the opportunity cost of traveling to and from health provider decreases. The Kernel Density Estimation of the model show disparities in healthcare accessibility with extensive pockets of poor accessibility in rural and peripheral areas in Texas, when using hospitals’ location and number of hospital beds or counties’ centroid and data on Primary Care Physician. The model can be beneficially used to evaluate policies indicative of changes in the provision of health services, such as closures of rural hospitals or capacity increases, potentially have spatially very differentiated accessibility outcomes.
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Notes
The Stirling approximation is given by lnx ! = x(lnx − 1).
The value of the coefficient β is often unknown (Talen and Anselin 1998), particularly for health services. If we use β = − 3, means that α varies around −3.57 when μ varies around 0.05. α approximates to the distance decay parameter estimate of 3.64 found by Griffith (2009) that analyzed Texas Journey to work Flows in Texas Counties. Given that out-of-pocket healthcare spending represents 5% of income in 2008 (Foster 2016), we will assume =0.05, i.e. the share of income spent on traveling to and from health provider is around 5%.
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Funding
Funding from Fundação para a Ciência e Tecnologia, under UID/GES/00315/2013 grant is gratefully acknowledged. The funding body had no influence in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
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de Mello-Sampayo, F. Spatial Interaction Healthcare Accessibility Model – an Application to Texas. Appl. Spatial Analysis 11, 739–751 (2018). https://doi.org/10.1007/s12061-018-9284-4
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DOI: https://doi.org/10.1007/s12061-018-9284-4