| Title: | Optimal allocation of physicians improves accessibility and workload disparities in stroke care |
| Authors: | Ohashi, Kazuki Browse this author →KAKEN DB |
| Osanai, Toshiya Browse this author →KAKEN DB |
| Bando, Kyohei Browse this author |
| Fujiwara, Kensuke Browse this author |
| Tanikawa, Takumi Browse this author →KAKEN DB |
| Tani, Yuji Browse this author →KAKEN DB |
| Takamiya, Soichiro Browse this author |
| Sato, Hirotaka Browse this author |
| Morii, Yasuhiro Browse this author →KAKEN DB |
| Ishikawa, Tomoki Browse this author →KAKEN DB |
| Ogasawara, Katsuhiko Browse this author →KAKEN DB |
| Keywords: | Two-step floating catchment area method |
| Quadratic programming |
| Potential crowdedness index |
| Spatial accessibility |
| Mechanical thrombectomy |
| Primary Stroke center |
| Issue Date: | 7-Nov-2023 |
| Publisher: | BMC |
| Journal Title: | International journal for equity in health |
| Volume: | 22 |
| Issue: | 1 |
| Start Page: | 233 |
| Publisher DOI: | 10.1186/s12939-023-02036-9 |
| PMID: | 37936211 |
| Abstract: | Background: Inequalities in access to stroke care and the workload of physicians have been a challenge in recent times. This may be resolved by allocating physicians suitable for the expected demand. Therefore, this study analyzes whether reallocation using an optimization model reduces disparities in spatial access to healthcare and excessive workload. Methods: This study targeted neuroendovascular specialists and primary stroke centers in Japan and employed an optimization model for reallocating neuroendovascular specialists to reduce the disparity in spatial accessibility to stroke treatment and workload for neuroendovascular specialists in Japan. A two-step floating catchment area method and an inverted two-step floating catchment area method were used to estimate the spatial accessibility and workload of neuroendovascular specialists as a potential crowdedness index. Quadratic programming has been proposed for the reallocation of neuroendovascular specialists. Results: The reallocation of neuroendovascular specialists reduced the disparity in spatial accessibility and the potential crowdedness index. The standard deviation (SD) of the demand-weighted spatial accessibility index improved from 125.625 to 97.625. Simultaneously, the weighted median spatial accessibility index increased from 2.811 to 3.929. Additionally, the SD of the potential crowdedness index for estimating workload disparity decreased from 10,040.36 to 5934.275 after optimization. The sensitivity analysis also showed a similar trend of reducing disparities. Conclusions: The reallocation of neuroendovascular specialists reduced regional disparities in spatial accessibility to healthcare, potential crowdedness index, and disparities between facilities. Our findings contribute to planning health policies to realize equity throughout the healthcare system. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/91134 |
| 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)
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