https://doi.org/10.4081/gh.2020.891
Spatial accessibility to emergency care in Sichuan province in China
Submitted: 24 April 2020
Accepted: 9 July 2020
Published: 29 December 2020
Accepted: 9 July 2020
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Timely access to emergency care can substantially improve overall population's health outcomes. However, currently existed evidence focusing on access to emergency care in China remains insufficient. A better understanding of emergency care from the perspective of spatial accessibility is therefore essential to assist in future healthcare planning. This study provided a brief introduction to the emergency medical service system of China, and assessed the spatial accessibility of emergency care as well as its associated social-economic characteristics based on Sichuan province. Based on populational and hospital administrative data in 2018, we employed the nearest-neighbor method to measure the spatial accessibility while identifying its associated social-economic factors via conventional Ordinary Least Square (OLS) model. The shortest travel time analysis reported a relatively high level of overall spatial accessibility to emergency care in Sichuan. However, substantial geographical disparity in accessibility could nevertheless be observed throughout the province, with the eastern area presenting much higher accessibility than the western area. Regression results suggested that county-level discrepancies in accessibility could be significantly attributed to the variance in local economic development, urbanization level and administrative area. These findings indicated that long-term efforts need to be made by central government on optimizing the allocation of healthcare resources, as well as on fortifying financial support and providing preferential policies for economically disadvantaged regions.
Berke, E. M., and X. Shi. 2009. Computing travel time when the exact address is unknown: a comparison of point and polygon ZIP code approximation methods. International Journal of Health Geographics 8 (1):23.
DOI: https://doi.org/10.1186/1476-072X-8-23
Bhaduri, B., E. Bright, P. Coleman, and J. J. G. Dobson. 2002. LandScan: Locating people is what matters. 5.
Bhutta, Z. A., J. K. Das, R. Bahl, J. E. Lawn, R. A. Salam, V. K. Paul, M. J. Sankar, H. Blencowe, A. Rizvi, V. B. Chou, and N. Walker. 2014. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet 384 (9940):347-370.
Calvello, E. J. B., M. Broccoli, N. Risko, C. Theodosis, V. Y. Totten, M. S. Radeos, P. Seidenberg, and L. Wallis. 2013. Emergency Care and Health Systems: Consensus-based Recommendations and Future Research Priorities. Academic Emergency Medicine 20 (12):1278-1288.
DOI: https://doi.org/10.1111/acem.12266
Chinese Ministry of Health. 1980. Opinions on strengthening urban emergency care.
Chinese Ministry of Health. 1994. Medical Institution Management Regulations.
Dormann, C. F., J. Elith, S. Bacher, C. Buchmann, G. Carl, G. Carré, J. R. G. Marquéz, B. Gruber, B. Lafourcade, P. J. Leitão, T. Münkemüller, C. McClean, P. E. Osborne, B. Reineking, B. Schröder, A. K. Skidmore, D. Zurell, and S. Lautenbach. 2013. Collinearity: a review of methods to deal with it and a simulation study evaluating their performance. Ecography 36 (1):27-46.
DOI: https://doi.org/10.1111/j.1600-0587.2012.07348.x
Gauss, T., F.-X. Ageron, M.-L. Devaud, G. Debaty, S. Travers, D. Garrigue, M. Raux, A. Harrois, P. Bouzat, and I. for the French Trauma Research. 2019. Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency Medicine System. JAMA Surgery 154 (12):1117-1124.
DOI: https://doi.org/10.1001/jamasurg.2019.3475
Guagliardo, M. F. 2004. Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics 3 (1):3.
DOI: https://doi.org/10.1186/1476-072X-3-3
Juran, S., P. N. Broer, S. J. Klug, R. C. Snow, E. A. Okiro, P. O. Ouma, R. W. Snow, A. J. Tatem, J. G. Meara, and V. A. Alegana. 2018. Geospatial mapping of access to timely essential surgery in sub-Saharan Africa. BMJ Global Health 3 (4):e000875.
DOI: https://doi.org/10.1136/bmjgh-2018-000875
Khubchandani, J. A., C. Shen, D. Ayturk, C. I. Kiefe, and H. P. Santry. 2018. Disparities in access to emergency general surgery care in the United States. Surgery 163 (2):243-250.
DOI: https://doi.org/10.1016/j.surg.2017.07.026
Liu, Y., Y. Jiang, S. Tang, J. Qiu, X. Zhong, and Y. Wang. 2015. Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city. International Journal for Equity in Health 14 (1):150.
DOI: https://doi.org/10.1186/s12939-015-0282-8
Lopez, A. D., and C. C. J. L. Murray. 1998. The global burden of disease, 1990–2020. Nature Medicine 4 (11):1241-1243.
DOI: https://doi.org/10.1038/3218
Mathison, D. J., J. M. Chamberlain, N. M. Cowan, R. N. Engstrom, L. Y. Fu, A. Shoo, and S. J. J. A. P. Teach. Primary Care Spatial Density and Nonurgent Emergency Department Utilization: A New Methodology for Evaluating Access to Care. Academic Pediatrics 13 (3):278-285.
DOI: https://doi.org/10.1016/j.acap.2013.02.006
Meara, J. G., A. J. M. Leather, L. Hagander, B. C. Alkire, N. Alonso, E. A. Ameh, S. W. Bickler, L. Conteh, A. J. Dare, J. Davies, E. D. Mérisier, S. El-Halabi, P. E. Farmer, A. Gawande, R. Gillies, S. L. M. Greenberg, C. E. Grimes, R. L. Gruen, E. A. Ismail, T. B. Kamara, C. Lavy, G. Lundeg, N. C. Mkandawire, N. P. Raykar, J. N. Riesel, E. Rodas, J. Rose, N. Roy, M. G. Shrime, R. Sullivan, S. Verguet, D. Watters, T. G. Weiser, I. H. Wilson, G. Yamey, and W. Yip. 2015. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet 386 (9993):569-624.
DOI: https://doi.org/10.1016/S0140-6736(15)60160-X
Ministry of Civil Affairs. 2018. Statistical report of administrative divisions in China.
National Bureau of Statistics of China. 2019. China statistical yearbook 2018. National Bureau of Statistics of China, Beijing, China.
Nishikawa, Y., M. Tsubokura, Y. Takahashi, S. Nomura, A. Ozaki, Y. Kimura, T. Morita, T. Sawano, T. Oikawa, and T. Nakayama. 2019. Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study. BMJ Open 9 (2):e023836.
DOI: https://doi.org/10.1136/bmjopen-2018-023836
Norton, R., and O. Kobusingye. 2013. Injuries. New England Journal of Medicine 368 (18):1723-1730.
DOI: https://doi.org/10.1056/NEJMra1109343
Ouma, P. O., J. Maina, P. N. Thuranira, P. M. Macharia, V. A. Alegana, M. English, E. A. Okiro, and R. W. Snow. 2018. Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis. The Lancet Global Health 6 (3):e342-e350.
DOI: https://doi.org/10.1016/S2214-109X(17)30488-6
Pan, J., H. Liu, X. Wang, H. Xie, and P. L. Delamater. 2015. Assessing the spatial accessibility of hospital care in Sichuan Province, China. Geospatial health 10 (2).
DOI: https://doi.org/10.4081/gh.2015.384
Pan, J., H. Zhao, X. Wang, and X. Shi. 2016. Assessing spatial access to public and private hospitals in Sichuan, China: The influence of the private sector on the healthcare geography in China. Social Science & Medicine 170:35-45.
DOI: https://doi.org/10.1016/j.socscimed.2016.09.042
Ren, Y., P. Qian, Z. Duan, Z. Zhao, J. Pan, and M. Yang. 2017. Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China. BMC Public Health 17 (1):750.
DOI: https://doi.org/10.1186/s12889-017-4765-y
Shen, Y., H. Yan, K. Reija, Q. Li, S. Xiao, J. Gao, and Z. Zhou. 2014. Equity in use of maternal health services in Western Rural China: a survey from Shaanxi province. BMC Health Services Research 14 (1):155.
DOI: https://doi.org/10.1186/1472-6963-14-155
Statistics Bureau of Sichuan. 2019. Sichuan Province Statistical Yearbook 2018.
Tan, X., X. Liu, and H. J. V. i. H. R. I. Shao. 2017. Healthy China 2030: A Vision for Health Care. 12:112.
DOI: https://doi.org/10.1016/j.vhri.2017.04.001
Tansley, G., N. Schuurman, O. Amram, and N. Yanchar. 2015. Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis. PLOS ONE 10 (11):e0141113.
DOI: https://doi.org/10.1371/journal.pone.0141113
Tansley, G., N. Schuurman, M. Bowes, M. Erdogan, R. Green, M. Asbridge, and N. Yanchar. 2019. Effect of predicted travel time to trauma care on mortality in major trauma patients in Nova Scotia. Canadian journal of surgery. Journal canadien de chirurgie 62 (2):123-130.
DOI: https://doi.org/10.1503/cjs.004218
Wang, X., H. Yang, Z. Duan, and J. Pan. 2018. Spatial accessibility of primary health care in China: A case study in Sichuan Province. Social Science & Medicine 209:14-24.
DOI: https://doi.org/10.1016/j.socscimed.2018.05.023
World Health Assembly. 2007. Health systems: emergency-care systems. WHA Resolution 60.2221–23.
Wu, J. 2018. Measuring inequalities in the demographical and geographical distribution of physicians in China: Generalist versus specialist. The International Journal of Health Planning and Management 33 (4):860-879.
DOI: https://doi.org/10.1002/hpm.2539
Zhang, T.-T., Z.-G. Wang, W. Huang, and S.-B. Li. 2017. A design approach of wide-speed-range vehicles based on the cone-derived theory. Aerospace Science and Technology 71:42-51.
DOI: https://doi.org/10.1016/j.ast.2017.09.010
How to Cite
Tang, X., Deng, Y., Yang, H. ., Tian, F., Li, Y., & Pan, J. (2020). Spatial accessibility to emergency care in Sichuan province in China. Geospatial Health, 15(2). https://doi.org/10.4081/gh.2020.891
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