Revealed versus potential spatial accessibility of healthcare and changing patterns during the COVID-19 pandemic.
Journal
Communications medicine
ISSN: 2730-664X
Titre abrégé: Commun Med (Lond)
Pays: England
ID NLM: 9918250414506676
Informations de publication
Date de publication:
03 Nov 2023
03 Nov 2023
Historique:
received:
12
01
2023
accepted:
12
10
2023
medline:
4
11
2023
pubmed:
4
11
2023
entrez:
4
11
2023
Statut:
epublish
Résumé
Timely access to healthcare is essential but measuring access is challenging. Prior research focused on analyzing potential travel times to healthcare under optimal mobility scenarios that do not incorporate direct observations of human mobility, potentially underestimating the barriers to receiving care for many populations. We introduce an approach for measuring accessibility by utilizing travel times to healthcare facilities from aggregated and anonymized smartphone Location History data. We measure these revealed travel times to healthcare facilities in over 100 countries and juxtapose our findings with potential (optimal) travel times estimated using Google Maps directions. We then quantify changes in revealed accessibility associated with the COVID-19 pandemic. We find that revealed travel time differs substantially from potential travel time; in all but 4 countries this difference exceeds 30 minutes, and in 49 countries it exceeds 60 minutes. Substantial variation in revealed healthcare accessibility is observed and correlates with life expectancy (⍴=-0.70) and infant mortality (⍴=0.59), with this association remaining significant after adjusting for potential accessibility and wealth. The COVID-19 pandemic altered the patterns of healthcare access, especially for populations dependent on public transportation. Our metrics based on empirical data indicate that revealed travel times exceed potential travel times in many regions. During COVID-19, inequitable accessibility was exacerbated. In conjunction with other relevant data, these findings provide a resource to help public health policymakers identify underserved populations and promote health equity by formulating policies and directing resources towards areas and populations most in need. Spatial access to healthcare facilities (i.e., how long people need to travel to reach care) is important for understanding public health, but hard to measure. Most research so far has focused on theoretical (potential) travel times. Using anonymized smartphone location history data, we measure actual (revealed) travel times to healthcare facilities in over 100 countries. We find that revealed travel times exceed theoretical travel times in many regions of the world, meaning that in reality people travel longer to get healthcare. Our data also show that inequities in travel time became worse during the COVID-19 pandemic. When combined with other data, these results can help policymakers identify areas and populations at need, and direct resources to improve public health.
Sections du résumé
BACKGROUND
BACKGROUND
Timely access to healthcare is essential but measuring access is challenging. Prior research focused on analyzing potential travel times to healthcare under optimal mobility scenarios that do not incorporate direct observations of human mobility, potentially underestimating the barriers to receiving care for many populations.
METHODS
METHODS
We introduce an approach for measuring accessibility by utilizing travel times to healthcare facilities from aggregated and anonymized smartphone Location History data. We measure these revealed travel times to healthcare facilities in over 100 countries and juxtapose our findings with potential (optimal) travel times estimated using Google Maps directions. We then quantify changes in revealed accessibility associated with the COVID-19 pandemic.
RESULTS
RESULTS
We find that revealed travel time differs substantially from potential travel time; in all but 4 countries this difference exceeds 30 minutes, and in 49 countries it exceeds 60 minutes. Substantial variation in revealed healthcare accessibility is observed and correlates with life expectancy (⍴=-0.70) and infant mortality (⍴=0.59), with this association remaining significant after adjusting for potential accessibility and wealth. The COVID-19 pandemic altered the patterns of healthcare access, especially for populations dependent on public transportation.
CONCLUSIONS
CONCLUSIONS
Our metrics based on empirical data indicate that revealed travel times exceed potential travel times in many regions. During COVID-19, inequitable accessibility was exacerbated. In conjunction with other relevant data, these findings provide a resource to help public health policymakers identify underserved populations and promote health equity by formulating policies and directing resources towards areas and populations most in need.
Spatial access to healthcare facilities (i.e., how long people need to travel to reach care) is important for understanding public health, but hard to measure. Most research so far has focused on theoretical (potential) travel times. Using anonymized smartphone location history data, we measure actual (revealed) travel times to healthcare facilities in over 100 countries. We find that revealed travel times exceed theoretical travel times in many regions of the world, meaning that in reality people travel longer to get healthcare. Our data also show that inequities in travel time became worse during the COVID-19 pandemic. When combined with other data, these results can help policymakers identify areas and populations at need, and direct resources to improve public health.
Autres résumés
Type: plain-language-summary
(eng)
Spatial access to healthcare facilities (i.e., how long people need to travel to reach care) is important for understanding public health, but hard to measure. Most research so far has focused on theoretical (potential) travel times. Using anonymized smartphone location history data, we measure actual (revealed) travel times to healthcare facilities in over 100 countries. We find that revealed travel times exceed theoretical travel times in many regions of the world, meaning that in reality people travel longer to get healthcare. Our data also show that inequities in travel time became worse during the COVID-19 pandemic. When combined with other data, these results can help policymakers identify areas and populations at need, and direct resources to improve public health.
Identifiants
pubmed: 37923904
doi: 10.1038/s43856-023-00384-9
pii: 10.1038/s43856-023-00384-9
pmc: PMC10624905
doi:
Types de publication
Journal Article
Langues
eng
Pagination
157Informations de copyright
© 2023. The Author(s).
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