Skip to main content

Advertisement

SpringerLink
Log in

Landscapes of healthcare utilization during a dengue fever outbreak in an urban environment of Colombia

  • Published:
Environmental Monitoring and Assessment Aims and scope Submit manuscript

Abstract

The well-being of a population and its health are influenced by a myriad of socioeconomic and environmental factors that interact across a wide range of scales, from the individual to the national and global levels. One of these factors is the provision of health services, which is regulated by both demand and supply. Although an adequate provision can significantly improve health outcomes of a population, lopsided flow of patients to specific health centers can result in serious disparities and potentially delay the timeliness of a diagnosis. In this paper, utilization patterns during an epidemic of dengue fever in the city of Cali, Colombia for the year 2010 are investigated. Specifically, the objectives are to (1) identify health facilities that exhibit patterns of over- and underutilization, (2) determine where patients who are being diagnosed at a particular facility originate from, and (3) whether patients are traveling to their closest facility and hence (4) estimate how far patients are willing to travel to be diagnosed and treated for dengue fever. Analysis is further decomposed by age group and by gender, in an attempt to test whether utilization patterns drastically change according to these variables. Answers to these questions can help health authorities plan for future epidemics, for instance, by providing guidelines as to which facilities require more resources and by improving the organization of health prevention campaigns to direct population seeking health assistance to use facilities that are underutilized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  • Abadia, C. E., & Oviedo, D. G. (2009). Bureaucratic itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems. Social Science & Medicine, 68, 1153–1160.

    Article  Google Scholar 

  • Alegana, V. a., Wright, J. a., Pentrina, U., Noor, A. M., Snow, R. W., & Atkinson, P. M. (2012). Spatial modelling of healthcare utilisation for treatment of fever in Namibia. International Journal of Health Geographics, 11, 6.

    Article  Google Scholar 

  • Alliance, T. W. R. (2015). Healthy mothers make a healthy world. http://whiteribbonalliance.org/. April 8, 2015.

  • Al-Taiar, A., Clark, A., Longenecker, J. C., & Whitty, C. J. M. (2010). Physical accessibility and utilization of health services in Yemen. International Journal of Health Geographics, 9, 1–8.

    Article  Google Scholar 

  • Astell-Burt, T., Flowerdew, R., Boyle, P. J., & Dillon, J. F. (2011). Does geographic access to primary healthcare influence the detection of hepatitis C? Social Science & Medicine, 72, 1472–1481.

    Article  Google Scholar 

  • Bijl, R., de Graff, R., Hiripi, E., Kessler, R. C., Kohn, R., Offord, D. R., Ustun, T. B., Vicente, B., Vollebergh, W. A. M., Walters, E. E., & Wittchen, H.-U. (2003). The prevalence of treted and untereated mental disorders in five countries. Health Affairs, 22, 122–133.

    Article  Google Scholar 

  • Black, R., Cousens, S., Johnson, H. L., Lawn, J. e., Rudan, I., Bassani, d. g., Jha, P., Campbell, H., Walker, C. F., Cibulskis, R., Eisele, t., Liu, L., & Mathers, C. (2010). Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet, 375, 1969–1987.

    Article  Google Scholar 

  • Buor, D. (2003). Analysing the primacy of distance in the utilization of health services in the Ahafo-Ano South district, Ghana. International Journal of Health Planning and Management, 18, 293–311.

    Article  Google Scholar 

  • Cali, A. d. S. d. (2008). Cali en cifras. Cali: Alcaldia de Cali.

    Google Scholar 

  • Cali, S. d. S. P. M. d. (2010). Historia del dengue en Cali. Endemia o una continua epidemia. Cali: Secretaria de Salud Publica Municipal de Cali.

    Google Scholar 

  • Casas, I., Delmelle, E., & Varela, A. (2010). A space-time approach to diffusion of health service provision information. International Regional Science Review, 33(2), 134–156.

    Article  Google Scholar 

  • Casas, I., Delmelle, E., & Delmelle, E. C. (2017). Potential versus revealed access to care during a dengue fever outbreak. Journal of Transport & Health, 4, 18–29.

    Article  Google Scholar 

  • Delmelle, E., Casas, I., Rojas, J. H., & Varela, A. (2013a). Spatio-temporal patterns of dengue fever in Cali, Colombia. International Journal of Applied Geospatial Research, 4, 58–75.

    Article  Google Scholar 

  • Delmelle, E. M., Cassell, C. H., Dony, C., Radcliff, E., Tanner, J. P., Siffel, C., & Kirby, R. S. (2013b). Modeling travel impedance to medical care for children with birth defects using Geographic Information Systems. Birth Defects Research Part A: Clinical and Molecular Teratology, 97, 673–684.

    Article  CAS  Google Scholar 

  • Delmelle, E., Jia, M., Dony, C., Casas, I., & Tang, W. (2014a). Space-time visualization of dengue fever outbreaks. In: Kanaroglou, Delmelle, & Paez (Eds), Spatial analysis in health geography. Ashgate.

  • Delmelle, E. M., Zhu, H., Tang, W., & Casas, I. (2014b). A web-based geospatial toolkit for the monitoring of dengue fever. Applied Geography, 52, 144–152.

    Article  Google Scholar 

  • Delmelle, E., Hagenlocher, M., Kienberger, S., & Casas, I. (2016). A spatial model of socioeconomic and environmental determinants of dengue fever in Cali, Colombia. Acta Tropica, 164, 169–176.

    Article  Google Scholar 

  • Desjardins, M. R., Whiteman, A., Casas, I., & Delmelle, E. (2018). Space-time clusters and co-occurrence of chikungunya and dengue fever in Colombia from 2015 to 2016. Acta Tropica, 185, 77–85.

  • Eastin, M. D., Delmelle, E., Casas, I., Wexler, J., & Self, C. (2014). Intra-and interseasonal autoregressive prediction of dengue outbreaks using local weather and regional climate for a tropical environment in Colombia. The American Journal of Tropical Medicine and Hygiene, 91(3), 598–610.

    Article  Google Scholar 

  • Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access: influencing the demand side. Health Policy and Planning, 19, 69–79.

    Article  Google Scholar 

  • Ensor, T., & San, P. B. (1996). Access and payment for health care: the poor of Northern Vietnam. International Journal of Health Planning and Management, 11, 69–83.

    Article  CAS  Google Scholar 

  • Gabrysch, S., & Campbell, O. M. R. (2009). Still too far to walk: literature review of the determinants of delivery service use. BMC Preganancy and Childbirth, 9, 1–18.

    Article  Google Scholar 

  • Gabrysch, S., Cousens, S., Cox, J., & Campbell, O. M. R. (2011). The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS Medicine, 8, e1000394.

    Article  Google Scholar 

  • Ganathra, B. & Hirve, S. (1994. Male bias in health care utilization for under-fives in a rural community in western India. In Bulleting of the World Health Organization (pp. 101–104). W. H. Organization.

  • Garcia-Subirats, I., Vargas, I., Mogollon-Perez, A. S., De Paepe, P., da Silva, M. R., Unger, J. P., & Vazquez, M. L. (2014). Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of Central Colombia and north-eastern Brazil. Social Science & Medicine, 106, 204–213.

    Article  Google Scholar 

  • Gaviria, A., Medina, C., & Mejia, C. (2006). Evaluating the impact of health care reform in Colombia: from theory to practice. In CEDE (Ed.) U. d. l. Andes. Bogotá Colombia.

  • Gething, P. W., Noor, A. M., Zurovac, D., Atkinson, P. M., Hay, S. I., Nixon, M. S., & Snow, R. W. (2004). Empirical modelling of government health service use by children with fevers in Kenya. Acta Tropica, 91, 227–237.

    Article  Google Scholar 

  • Glassman, A. L., Escobar, M.-L., Giuffrida, A., & Giedion, U. (2009). From few to many: ten years of health insurance expansion in Colombia. In I.-A. D. B. T. B. Institution. New York: The Brookings Institution.

  • Hagenlocher, M., Delmelle, E., Casas, I., & Kienberger, S. (2013). Assessing socioeconomic vulnerability to dengue fever in Cali, Colombia: statistical vs expert-based modeling. International Journal of Health Geographics, 12(1), 36.

    Article  Google Scholar 

  • Hassan, A. R., Jiménez, J. C., & Montoya, R. C. (2013). The impact of subsidized health insurance on the poor in Colombia: evaluating the case of Medellín. Economía Aplicada, 17, 543–556.

    Article  Google Scholar 

  • Hine, J., & Kamruzzaman, M. (2012). Journeys to health services in Great Britain: an analysis of changing travel patterns 1985–2006. Health & Place, 18, 274–285.

    Article  Google Scholar 

  • Hohl, A., Zheng, M., Tang, W., Delmelle, E., & Casas, I. (2017). Spatiotemporal point pattern analysis using Ripley’s K function. Geospatial data science: techniques and applications. CRC Press, Boca Raton, FL.

  • Jia, P., & Xierali, I. M. (2015). Disparities in patterns of health care travel among inpatients diagnosed with congestive heart failure, Florida, 2011. Preventing Chronic Disease, 12, E150.

    Article  Google Scholar 

  • Khun, S., & Manderson, L. (2007). Health seeking and access to care for children with suspected dengue in Cambodia: an ethnographic study. BMC Public Health, 7, 262.

    Article  Google Scholar 

  • Khun, S., & Manderson, L. (2008). Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia. International Journal for Equity in Health, 7, 10.

    Article  Google Scholar 

  • Kienberger, S., Hagenlocher, M., Delmelle, E., & Casas, I. (2013). A WebGIS tool for visualizing and exploring socioeconomic vulnerability to dengue fever in Cali, Colombia. Geospatial Health, 8(1), 313–316.

    Article  Google Scholar 

  • Kittayapong, P., Yoksan, S., Chansang, U., Chansang, C., & Bhumiratana, A. (2008). Suppression of dengue transmission by application of integrated vector control strategies at sero-positive GIS-based foci. The American Journal of Tropical Medicine and Hygiene, 78, 70–76.

    Article  Google Scholar 

  • Kwan, M.-P., Casas, I., & Schmitz, B. C. (2004). Protection of geoprivacy and accuracy of spatial information: how effective are geographical masks? Cartographica, 39, 15–28.

    Article  Google Scholar 

  • Lee, S. Y., Xue, Q.-l., Spira, A. P., & Lee, H. B. (2014). Racial and ethnic differences in depressive subtypes and access to mental health care in the United States. Journal of Affective Disorders, 155, 130–137.

    Article  Google Scholar 

  • Målqvist, M., Sohel, N., Do, T. T., Eriksson, L., & Persson, L.-Å. (2010). Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern Vietnam. BMC Public Health, 10, 1–9.

    Article  Google Scholar 

  • Masters, S. H., Burstein, R., Amofah, G., Abaogye, P., Kumar, S., & Hanlon, M. (2013). Travel time to maternity care and its effect on utilization in rural Ghana: a multilevel analysis. Social Science & Medicine, 93, 147–154.

    Article  Google Scholar 

  • Méndez, F., Barreto, M., Arias, J. F., Rengifo, G., Muñoz, J., Burbano, M. E., & Parra, B. (2006). Human and mosquito infections by dengue viruses during and after epidemics in a dengue-endemic region of Colombia. The American Journal of Tropical Medicine and Hygiene, 74, 678–683.

    Article  Google Scholar 

  • Noor, A. M., Zurovac, D., Hay, S. I., Ochola, S. A., & Snow, R. W. (2003). Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya. Tropical Medicine & International Health, 8, 917–926.

    Article  CAS  Google Scholar 

  • O’Donnell, O. (2007). Access to health care in developing countries: breaking down demand side barriers. Cadernos de Saúude Pública, 23.

  • Okanurak, K., Sornmani, S., & Indaratna, K. (1997). The cost of dengue hemorrhagic fever in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 28, 711–717.

    CAS  Google Scholar 

  • Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Rahman, M. H. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136, 161–171.

    Article  Google Scholar 

  • Ray, N., & Ebener, S. (2008). AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients. International Journal of Health Geographics, 7, 63.

    Article  Google Scholar 

  • Restrepo, L. D. E. (2006). El plan piloto de cali 1950. Revista Bitacora Urbano Territorial, 1, 222–223.

    Google Scholar 

  • Rojas, J. (2013). Dengue 2013—Semanas epidemiológicas (pp. 1–17). Cali: Secretaría de Salud Municipal.

    Google Scholar 

  • Romero-Vivas, C. M., Leake, C. J., & Falconar, a. K. (1998). Determination of dengue virus serotypes in individual Aedes aegypti mosquitoes in Colombia. Medical and Veterinary Entomology, 12, 284–288.

    Article  CAS  Google Scholar 

  • Schiefelbein, E. L., Olson, J. a., & Moxham, J. D. (2014). Patterns of health care utilization among vulnerable populations in Central Texas using data from a regional Health Information Exchange. Journal of Health Care for the Poor and Underserved, 25, 37–51.

    Article  Google Scholar 

  • Simmons, C., Farrar, J. J., van Vinh Chau, N., & Wills, B. (2012). Dengue. 366, 1423–1432.

  • Sipsma, H., Callands, T. A., Bradley, E., Harris, B., Johnson, B., & Hansen, N. B. (2013). Healthcare utilisation and empowerment among women in Liberia. Journal of Epidemiology and Community Health, 67, 953–959.

    Article  Google Scholar 

  • Staff (2013). Dos clínicas de Cali están en el ‘ranking’ de las mejores de Latinoamérica. El País September 18.

  • Staff (2017a). Historia: Club Noel. http://clubnoel.org/content/quienes-somos/sobre-el-club-noel/historia/. April 13, 2017.

  • Staff (2017b). Hospital Universitario del Valle. http://www.huv.gov.co/web/node/8. April 13, 2017.

  • Stephens, J. M., Brotherton, S., Dunning, S. C., Emerson, L. C., Gilbertson, D. T., Harrison, D. J., Kochevar, J. J., McClellan, A. C., McClellan, W. M., Wan, S., & Gitlin, M. (2013). Geographic disparities in patient travel for dialysis in the United States. The Journal of Rural Health, 29, 339–348.

    Google Scholar 

  • Tanser, F., Gijsbertsen, B., & Herbst, K. (2006). Modelling and understanding primary health care accessibility and utilization in rural South Africa: an exploration using a geographical information system. Social Science & Medicine, 63, 691–705.

    Article  Google Scholar 

  • UNICEF. (2015). The state of the world’s children 2015. New York: UNICEF.

    Google Scholar 

  • Vargas, I., Vázquez, M. L., Mogollón-Pérez, A. S., & Unger, J.-P. (2010). Barriers of access to care in a managed competition model: lessons from Colombia. BMC Health Services Research, 10, 297.

    Article  Google Scholar 

  • Yao, J., Murray, A. T., & Agadjanian, V. (2013). A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Social Science & Medicine, 96, 60–68.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Louisiana Tech University, Ruston, LA, 71272, USA

    Irene Casas

  2. University of North Carolina at Charlotte, Charlotte, NC, 28223, USA

    Eric Delmelle

Authors
  1. Irene Casas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric Delmelle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric Delmelle.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Geospatial Technology in Environmental Health Applications

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Casas, I., Delmelle, E. Landscapes of healthcare utilization during a dengue fever outbreak in an urban environment of Colombia. Environ Monit Assess 191 (Suppl 2), 279 (2019). https://doi.org/10.1007/s10661-019-7415-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10661-019-7415-2

Keywords

Search

Navigation