Rural and Minority Health Research Center, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, University of South Carolina, SC, USA; Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.
Rural and Minority Health Research Center, University of South Carolina, Columbia, SC, USA.
Spat Spatiotemporal Epidemiol. 2021 Jun;37:100414. doi: 10.1016/j.sste.2021.100414. Epub 2021 Mar 6.
Colonoscopy use has increased since Medicare began covering screening for average-risk persons. Our objective was to describe changes in spatial access to colonoscopy in South Carolina (SC) between 2000 and 2014.
Using data from the SC Ambulatory Surgery Database, we created annual ZIP Code Tabulation Area (ZCTA) spatial accessibility scores. We assessed changes in accessibility, colonoscopy supply, and potential demand, overall and by metropolitan designation. Spatial clustering was also explored.
Spatial accessibility decreased across both small rural and metropolitan ZCTAs but was significantly higher in metropolitan areas during the first part of the study period . The proportion of persons with no access to colonoscopy within 30 min increased over time but was consistently higher in small rural areas. Clusters of low accessibility grew over time.
The supply of colonoscopy facilities decreased relative to the potential demand, and clusters of low access increased, indicating a contraction of services.
自医疗保险开始覆盖一般风险人群的筛查以来，结肠镜检查的使用有所增加。我们的目的是描述 2000 年至 2014 年南卡罗来纳州（SC）结肠镜检查的空间可及性的变化。
使用来自南卡罗来纳州门诊手术数据库的数据，我们创建了年度邮政编码区（ZCTA）空间可达性评分。我们评估了整体和大都市指定的可达性、结肠镜检查供应和潜在需求的变化。还探索了空间聚类。
在整个小农村和大都市 ZCTA 中，空间可达性都有所下降，但在研究初期，大都市地区的可达性明显更高。在 30 分钟内无法接受结肠镜检查的人数比例随着时间的推移而增加，但在小农村地区一直较高。低可达性的聚类随着时间的推移而增加。
相对于潜在需求，结肠镜检查设施的供应减少，低可达性聚类增加，表明服务收缩。
