https://doi.org/10.4081/gh.2023.1152

Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis

Vol. 18 No. 2 (2023)
Submitted: 14 September 2022
Accepted: 21 March 2023
Published: 3 July 2023
Colorectal cancer, screening, spatial analysis, accessibility, location-allocation, China
Abstract Views: 1299
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Supplementary Materials: 65
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Authors

Jiaqi Huang
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.
Yichen Chen
Center for Disease Control and Prevention, Pudong New Area, Shanghai, China.
Gu Liu
Department of General Surgery, the first people's Hospital of Chenzhou, Hunan, China.
Wei Tu
Department of Geology and Geography, Georgia Southern University, Statesboro, GA, United States.
Robert Bergquist
Ingerod, Brastad, Sweden.
Michael P. Ward
Faculty of Veterinary Science, University of Sydney, NSW, Australia.
Jun Zhang
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.
Shuang Xiao
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.
Jie Hong
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.
Zheng Zhao
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.
Xiaopan Li
Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China; Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China.
Zhijie Zhang
epistat@gmail.com
Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China.

Screening programmes are important for early diagnosis and treatment of colorectal cancer (CRC) but they are not equally efficient in all locations. Depending on which hospital people belong to, they often are not willing to follow up even after a positive result, resulting in a lower-than-expected overall detection rate. Improved allocation of health resources would increase the program’s efficiency and assist hospital accessibility. A target population exceeding 70,000 people and 18 local hospitals were included in the investigation of an optimization plan based on a locationallocation model. We calculated the hospital service areas and the accessibility for people in communities to CRC-screening hospitals using the Huff Model and the Two-Step Floating Catchment Area (2SFCA) approach. We found that only 28.2% of the residents with initially a positive screening result had chosen followup with colonoscopy and significant geographical differences in spatial accessibility to healthcare services indeed exist. The lowest accessibility was found in the Southeast, including the Zhangjiang, Jichang and Laogang communities with the best accessibility mainly distributed near the city centre of Lujiazui; the latter also had relatively a high level of what is called “ineffective screening” as it represents wasteful resource allocation. It is recommended that Hudong Hospital should be chosen instead of Punan Hospital as the optimization, which can improve the service population of each hospital and the populations served per colonoscope. Based on our results, changes in hospital configuration in colorectal cancer screening programme are needed to achieve adequate population coverage and equitable facility accessibility. Planning of medical services should be based on the spatial distribution trends of the population served.

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How to Cite

Huang, J., Chen, Y., Liu, G., Tu, W., Bergquist, R., P. Ward, M., Zhang, J., Xiao, S., Hong, J., Zhao, Z., Li, X., & Zhang, Z. (2023). Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis. Geospatial Health, 18(2). https://doi.org/10.4081/gh.2023.1152
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