Bozorgi Parisa, Eberth Jan M, Eidson Jeannie P, Porter Dwayne E
Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
South Carolina Department of Health and Environmental Control (SCDHEC), Columbia, SC 29201, USA.
Int J Environ Res Public Health. 2021 Apr 16;18(8):4246. doi: 10.3390/ijerph18084246.
Opioid dependence and opioid-related mortality have been increasing in recent years in the United States. Available and accessible treatments may result in a reduction of opioid-related mortality. This work describes the geographic variation of spatial accessibility to opioid treatment programs (OTPs) and identifies areas with poor access to care in South Carolina. The study develops a new index of access that builds on the two-step floating catchment area (2SFCA) method, and has three dimensions: a facility attractiveness index, defined by services rendered incorporated into the Huff Model; a facility catchment area, defined as a function of facility attractiveness to account for variable catchment size; and a Social Vulnerability Index (SVI) to account for nonspatial factors that mitigate or compound the impacts of spatial access to care. Results of the study indicate a significant variation in access to OTPs statewide. Spatial access to OTPs is low across the entire state except for in a limited number of metropolitan areas. The majority of the population with low access (85%) live in areas with a moderate-to-high levels of social vulnerability. This research provides more realistic estimates of access to care and aims to assist policymakers in better targeting disadvantaged areas for OTP program expansion and resource allocation.
近年来，美国的阿片类药物依赖和与阿片类药物相关的死亡率一直在上升。可得且可及的治疗可能会降低与阿片类药物相关的死亡率。这项工作描述了阿片类药物治疗项目（OTP）空间可及性的地理差异，并确定了南卡罗来纳州医疗服务可及性差的地区。该研究基于两步浮动集水区（2SFCA）方法开发了一种新的可及性指数，它有三个维度：一个设施吸引力指数，由纳入赫夫模型的提供的服务定义；一个设施集水区，定义为设施吸引力的函数以考虑可变的集水区大小；以及一个社会脆弱性指数（SVI），以考虑减轻或加剧医疗服务空间可及性影响的非空间因素。研究结果表明该州各地OTP的可及性存在显著差异。除了少数大都市区外，该州各地OTP的空间可及性都很低。大多数可及性低的人群（85%）生活在社会脆弱性程度为中度到高度的地区。这项研究提供了更现实的医疗服务可及性估计，并旨在帮助政策制定者更好地确定OTP项目扩展和资源分配的弱势地区。
