Your browser doesn't support javascript.
loading
Comparing absolute and relative distance and time travel measures of geographic access to healthcare facilities in rural Haiti.
Bhangdia, Kayleigh Pavitra; Iyer, Hari S; Joseph, Jean Paul; Dorne, Rubin Lemec; Mukherjee, Joia; Fadelu, Temidayo.
Afiliação
  • Bhangdia KP; Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA kbhangdia@gmail.com.
  • Iyer HS; Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
  • Joseph JP; Division of Population Science, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Dorne RL; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
  • Mukherjee J; Partners In Health/Zanmi Lasante, Mirebalais, Haiti.
  • Fadelu T; Partners In Health/Zanmi Lasante, Mirebalais, Haiti.
BMJ Open ; 12(5): e056123, 2022 05 24.
Article em En | MEDLINE | ID: mdl-35613799
INTRODUCTION: While travel distance and time are important proxies of physical access to health facilities, obtaining valid measures with an appropriate modelling method remains challenging in many settings. We compared five measures of geographic accessibility in Haiti, producing recommendations that consider available analytic resources and geospatial goals. METHODS: Eight public hospitals within the ministry of public health and population were included. We estimated distance and time between hospitals and geographic centroids of Haiti's section communes and population-level accessibility. Geographic feature data were obtained from public administrative databases, academic research databases and government satellites. We used validated geographic information system methods to produce five geographic access measures: (1) Euclidean distance (ED), (2) network distance (ND), (3) network travel time (NTT), (4) AccessMod 5 (AM5) distance (AM5D) and (5) AM5 travel time (AM5TT). Relative ranking of section communes across the measures was assessed using Pearson correlation coefficients, while mean differences were assessed using analysis of variance (ANOVA) and pairwise t-tests. RESULTS: All five geographic access measures were highly correlated (range: 0.78-0.99). Of the distance measures, ED values were consistently the shortest, followed by AM5D values, while ND values were the longest. ND values were as high as 2.3 times ED values. NTT models generally produced longer travel time estimates compared with AM5TT models. ED consistently overestimated population coverage within a given threshold compared with ND and AM5D. For example, population-level accessibility within 15 km of the nearest studied hospital in the Center department was estimated at 68% for ED, 50% for AM5D and 34% for ND. CONCLUSION: While the access measures were highly correlated, there were significant differences in the absolute measures. Consideration of the benefits and limitations of each geospatial measure together with the intended purpose of the estimates, such as relative proximity of patients or service coverage, are key to guiding appropriate use.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Instalações de Saúde / Acessibilidade aos Serviços de Saúde Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Humans País/Região como assunto: Caribe / Haiti Idioma: En Revista: BMJ Open Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Instalações de Saúde / Acessibilidade aos Serviços de Saúde Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Humans País/Região como assunto: Caribe / Haiti Idioma: En Revista: BMJ Open Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido