Abstract
Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply and demand information. In this study, we proposed an optimal model with the three-step floating catchment area (3SFCA) to account for the supply to minimize variability in spatial accessibility. We used empirical dengue fever outbreak data in Tainan City, Taiwan in 2015 to demonstrate the dynamic change in spatial accessibility based on the epidemic trend. The x and y coordinates of dengue-infected patients with precision loss were provided publicly by the Tainan City government, and were used as our model’s demand. The spatial accessibility of heath care during the dengue outbreak from August to October 2015 was analyzed spatially and temporally by producing accessibility maps, and conducting capacity change analysis. This study also utilized the particle swarm optimization (PSO) model to decrease the spatial variation in accessibility and shortage areas of healthcare resources as the epidemic went on. The proposed method in this study can help decision makers reallocate healthcare resources spatially when the ratios of demand and supply surge too quickly and form clusters in some locations.
Highlights
Dengue fever is the most serious arboviral disease, and has become a major health problem in most tropical countries in recent decades [1]
Resultshighest accessibility is found in urban areas with service sites, while suburban areas
The spatial and temporal patterns of healthcare accessibility were evaluated and the impact of healthcare resources was simulated during a dengue outbreak
Summary
Dengue fever is the most serious arboviral disease, and has become a major health problem in most tropical countries in recent decades [1]. A recent estimate indicates that 390 million people annually have dengue infections, in which 96 million cases have clinical manifestations [2]. Centers for Disease Control (CDC) [3]. Among these cases, there were 22,777 cases in Tainan city, which is located in southern Taiwan. The demand for resources during the dengue outbreak in Tainan exceeded the capacity of individual health facilities. The management of hospital resources, including beds, equipment, and clinical manpower, and so on [4], in the existing hospital networks has become a significant issue [5]
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