Optimal allocation of physicians improves accessibility and workload disparities in stroke care

Ohashi, Kazuki; Osanai, Toshiya; Bando, Kyohei; Fujiwara, Kensuke; Tanikawa, Takumi; Tani, Yuji; Takamiya, Soichiro; Sato, Hirotaka; Morii, Yasuhiro; Ishikawa, Tomoki; Ogasawara, Katsuhiko

Optimal allocation of physicians improves accessibility and workload disparities in stroke care

Ohashi, Kazuki; Osanai, Toshiya; Bando, Kyohei et al.

International journal for equity in health, 2023, 22(1), 233

Permalink : https://hdl.handle.net/2115/91134

このアイテムのアクセス数:410件（2026-01-17 01:21 集計）

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https://doi.org/10.1186/s12939-023-02036-9			1

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/91134
タイトル	Optimal allocation of physicians improves accessibility and workload disparities in stroke care
著者	Ohashi, Kazuki ; Osanai, Toshiya ; Bando, Kyohei ; Fujiwara, Kensuke ; Tanikawa, Takumi ; Tani, Yuji ; Takamiya, Soichiro ; Sato, Hirotaka ; Morii, Yasuhiro ; Ishikawa, Tomoki ; Ogasawara, Katsuhiko
e-Rad_Researcher 20848527 著者名 Ohashi, Kazuki
e-Rad_Researcher 90622788 著者名 Osanai, Toshiya
著者名 Bando, Kyohei
著者名 Fujiwara, Kensuke
e-Rad_Researcher 40446539 著者名 Tanikawa, Takumi
e-Rad_Researcher 70768689 著者名 Tani, Yuji
著者名 Takamiya, Soichiro
著者名 Sato, Hirotaka
e-Rad_Researcher 70880574 著者名 Morii, Yasuhiro
e-Rad_Researcher 90802661 著者名 Ishikawa, Tomoki
e-Rad_Researcher 90322859 著者名 Ogasawara, Katsuhiko
言語	英語
キーワード	Two-step floating catchment area method
	Quadratic programming
	Potential crowdedness index
	Spatial accessibility
	Mechanical thrombectomy
	Primary Stroke center
発行日	2023-11-07
出版者	BMC
収録物名	International journal for equity in health
巻(号)	22(1)
ページ	233
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
PISSN	1475-9276
関連情報	PMID 37936211
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s12939-023-02036-9