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Relationship between accessibility and resources to treat acute ischemic stroke. Hokkaido, Japan : Analysis of inequality and coverage using geographic information systems

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Title: Relationship between accessibility and resources to treat acute ischemic stroke. Hokkaido, Japan : Analysis of inequality and coverage using geographic information systems
Authors: Ishikawa, Tomoki Browse this author
Mizuguchi, Hiro Browse this author
Murayama, Hiroshi Browse this author
Fujiwara, Kensuke Browse this author
Tanikawa, Takumi Browse this author →KAKEN DB
Kobayashi, Eiichi Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Keywords: Health services accessibility
Spatial analysis
Geographic information system (GIS)
Response time (RT)
Emergency medical services (EMS)
Issue Date: Dec-2019
Publisher: Elsevier
Journal Title: Health policy and technology
Volume: 8
Issue: 4
Start Page: 337
End Page: 342
Publisher DOI: 10.1016/j.hlpt.2019.10.001
Abstract: Objectives: This study aimed to clarify the relationship between the institution and resident with respect to accessibility to acute ischemic stroke (AIS) treatment in Hokkaido and to propose new methodology monitoring for accessibility to healthcare resources. Methods: This study involves the use of geographic information system (GIS) network analysis. We established hospital/clinic with one of the following conditions as resources for AIS treatment: (1) medical facility practicing AIS treatment, (2) having computed tomography (CT) equipment, (3) having angiography equipment, and (4) having AIS specialists (neurosurgeons). We evaluated the coverage of population resources using transport time between ambulance departure and arrival at the healthcare facility. Furthermore, we compared the population coverage rate using available resources and calculated a Gini coefficient to analyze its relation with inequality. Empirical analysis was performed, and public database for data collection was utilized. We calculated the rate of population coverage with a transport time within 10 min as an indicator of accessibility to medical resources by GIS. Results: The Gini coefficients of practicable facilities, CT, angiography, and neurosurgeons are 0.35, 0.16, 0.18, and 0.30, respectively. The inequality of accessibility differs depending on the resources, and Gini coefficients indicate that hospital/clinic and neurosurgeons were considered to have higher allocation inequalities than CT and angiography. Conclusions: Combining Gini coefficient and GIS network analysis in accessibility can be useful in quantifying and monitoring variation by region. We propose this combination as a new method for helping the government to make evidence-based healthcare planning. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.
Rights: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小笠原 克彦

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