Combining Transportation Network Models with Kernel Density Methods to Measure the Relative Spatial Accessibility of Pediatric Primary Care Services in Jefferson County, Kentucky

Combining Transportation Network Models with Kernel Density Methods to Measure the Relative Spatial Accessibility of Pediatric Primary Care Services in Jefferson County, Kentucky

Jeremiah J. Nieves (Department of Geography and Geo-Sciences, University of Louisville, Louisville, KY, USA)
Copyright: © 2015 |Pages: 19
DOI: 10.4018/ijagr.2015070103
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Abstract

When considering access to healthcare, the question of whether the provider is available and accessible must be answered before the question of cost. Most contemporary techniques of estimating the spatial accessibility of healthcare cannot simultaneously take into account transportation times and the spatially distributed service capacity of healthcare providers. This paper creates the Comprehensive Spatial Accessibility Rank (CSAR) model to calculate a relative estimate of spatial accessibility that can account for both public and private transportation and the spatial distribution of a service provider's capacity for service in relation to the distribution of a study area's population. It uses data for Jefferson County, Kentucky to show how the CSAR model could be used to identify possible disparities in accessing pediatric primary healthcare services. The CSAR model is able to detect relative disparities between defined subpopulations and or geographic regions, allowing for the comparison of the effects of physical infrastructure in access.
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Literature Review

Definition of Access

Distance to health care providers, while a more significant problem in rural areas, remains an important factor in the spatial accessibility of a provider in urban areas (Guagliardo, Ronzio, Cheung, Chacko, & Joseph, 2004). Jarvis’s Law states that there is an inverse relationship between the distance to a service location and the rate of utilization of that service location. However, in order for the question of accessibility to exist, there must be a supply of service (Joseph & Phillips, 1984).

Access is composed of stages, potential and realized, and dimensions, spatial and aspatial. Potential access focuses on the possible use of health services. Realized access is how health services are used once all barriers are surmounted (Anthamatten & Hazen, 2011). There are five main barriers between potential access and realized access: three are aspatial (affordability, accommodation, and acceptability) and two are spatial (availability and accessibility) (Penchansky & Thomas, 1981). Guagliardo (2004) suggests that, in urban areas, availability and accessibility should be considered simultaneously and be referred to as “Spatial Accessibility” (SA). SA takes into account the number of services an individual can select from (availability) and the travel impedance (accessibility) between an individual and locations of service.

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