Improving the measurement of the Korean emergency medical System's spatial accessibility

Abstract

Measuring spatial accessibility for healthcare service is an important prerequisite for public health policy decision. While existing literature offers spatial accessibility measures, applying those measures to healthcare services reveals some weaknesses for improvement. In this study, we propose an improved accessibility measure. The proposed measure is based on the floating catchment area method but improved in some aspects. We use two distance decay functions to distinguish their respective effects in measuring accessibility. A local distance decay function, expressed as a logistic cumulative density function, accounts for region-specific patient visit patterns. A global distance decay function, also defined as a logistic density function, incorporates patients’ inherent resistance to travel in the measure. To address the problem of potential demand estimation, which distorts the resulting accessibility values, we introduce effective potential demand which is defined as the ratio of potential demand to total nearby capacity by care providers as an adjustment factor. To examine the effectiveness, we apply the measure to identify the medically underserved areas in Korea for emergency medical services. Compared with the existing floating catchment area measure, the proposed measure provides more proper spatial accessibility information. © 2018 Elsevier Ltd