Evaluation of healthcare inequity for older adults: A spatio-temporal perspective

Abstract

Abstract: Introduction Population aging raises many fundamental questions for public health policymakers, one of which is how to address the inequity of medical services for older adults. Geographic information systems (GIS)-based accessibility has been widely employed to measure the inequity of access to healthcare facilities. However, the focus in literature lies generally on spatial patterns; few accessibility studies have focused on temporal inequity. This study focuses on the disparity of the elderly's healthcare inequity (EHI) in both spatial and temporal dimensions. Methods EHI is measured by the elderly's medical services accessibility (EMSA) scores. Based on a road network analysis with real-time traffic data acquired by a Python-based web crawler, a Gaussian two-step floating catchment area (2SFCA) method is employed to calculate EMSA scores. Sensitivity analysis is presented for three threshold times (i.e., 5, 15, and 30 min) and different intervals of a time of day (TOD) period. Results In the temporal patterns, the average EMSA (EMSA-avg) scores of daily variations vary from 0.0262 to 0.0556 at t0 = 5 min, from 0.0704 to 0.1073 at t0 = 15 min, and from 0.1734 to 0.2223 at t0 = 30 min. Meanwhile, three “low value intervals (LVIs)” exist in TOD period. In the spatial patterns, the areas with frequent traffic congestions or no nearby hospitals are characterized by low-level accessibility for the 5 min catchment, while the same level areas for the 30 min are far from the city centre and equipped with inconvenient public transportation. Conclusions The findings may help the policymakers in planning the medical service resources for the growing aging population and providing caregivers information for a timely and effective medical treatment.