Spatial dynamics of access to primary care for the medicaid population.
GIS mapping
Medicaid
Spatial system dynamics
health disparities
primary care
Journal
Health systems (Basingstoke, England)
ISSN: 2047-6965
Titre abrégé: Health Syst (Basingstoke)
Pays: England
ID NLM: 101602681
Informations de publication
Date de publication:
2020
2020
Historique:
received:
28
08
2018
accepted:
15
12
2018
entrez:
15
4
2020
pubmed:
28
12
2018
medline:
28
12
2018
Statut:
epublish
Résumé
Primary care (PC) has always been underestimated and underinvested by the United States health system. Our goal was to investigate the effect of Medicaid expansion and the Affordable Care Act (ACA) provisions on PC access in Broome County, NY, a county that includes both rural and urban areas, and can serve as a benchmark for other regions. We developed a spatial system dynamics model to capture different stages of PC access for the Medicaid population by using the health belief model constructs and simulate the effect of several hypothetical interventions on PC utilisation. The government data portals used as data sources for calibrating our model include the New York State Department of Health, the Medicaid Delivery System Reform Incentive Payment (DSRIP) dashboards, and the US census. In our unique approach, we integrated the simulation results within Geographical Information System (GIS) maps, to assess the influence of geospatial factors on PC access. Our results identify hot spot demographic areas that have poor access to PC service facilities due to transportation constraints and a shortage in PC providers. Our decision support tool informs policymakers about programmes with the strongest impact on improving access to care, considering spatial and temporal characteristics of a region.
Identifiants
pubmed: 32284852
doi: 10.1080/20476965.2018.1561159
pii: 1561159
pmc: PMC7144229
doi:
Types de publication
Journal Article
Langues
eng
Pagination
64-75Informations de copyright
© Operational Research Society 2018.
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