Abstract
This manuscript develops a theoretical spatial interaction model using the entropy approach to relax the assumption of the deterministic utility function. The spatial healthcare accessibility improves as the demand for healthcare increases or the opportunity cost of traveling to and from healthcare providers decreases. The empirical application used different spatial econometric techniques and multilevel modeling to evaluate the spatial distribution of existing hospitals in Texas and their social and economic correlates. To control for spatial autocorrelation, spatial autoregressive regression models were estimated, and geographically weighted regression models examined potential spatial non-stationarity. The multilevel modeling controlled for spatial autocorrelation and also allowed local variation and spatial non-stationarity. The empirical analysis showed that healthcare accessibility was not stationary in Texas in 2015, with areas of poor accessibility in rural and peripheral areas in Texas, when using hospitals’ location and county data. The model of spatial interaction applied to healthcare accessibility can be used to evaluate policies aiming at the provision of health services, such as closures of hospitals and capacity increases.
Highlights
One key economic factor explaining differences in healthcare accessibility to healthcare providers is income
The results of the theoretical framework suggest that spatial accessibility improves as the demand for healthcare services increases or the willingness to pay for traveling to and from healthcare providers decreases. de Mello-Sampayo [2] demonstrated the utility of spatial interaction models as a tool to assess spatial accessibility to healthcare services but using a different utility function and focusing on the supply side of the healthcare market
This study used different econometric techniques to evaluate the spatial distribution of healthcare accessibility subject to hospital service capacity, income per capita and low birth weight
Summary
One key economic factor explaining differences in healthcare accessibility to healthcare providers is income. The focus of this study is to set up a model with microeconomic foundations of spatial interaction to characterize the spatial accessibility pattern, where the utility function captures the health–wealth tradeoff when deciding to access healthcare providers. De Mello-Sampayo [2] demonstrated the utility of spatial interaction models as a tool to assess spatial accessibility to healthcare services but using a different utility function and focusing on the supply side of the healthcare market. To de Mello-Sampayo [2], the existence of spatial spillovers and externalities among healthcare providers is acknowledged in the empirical strategy applied in this study
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