Wang Changzhen, Wang Fahui, Onega Tracy
Department of Geography & Anthropology, Louisiana State University, Baton Rouge, LA 70803.
Department of Population Health Sciences, University of Utah; Huntsman Cancer Institute. Salt Lake City, UT 84112.
Travel Behav Soc. 2021 Jul;24:291-302. doi: 10.1016/j.tbs.2021.05.003. Epub 2021 May 15.
Spatial behavior of patients in utilizing health care reflects their travel burden or mobility, accessibility for medical service, and subsequently outcomes from treatment. This paper derives the best-fitting distance decay function to capture the spatial behaviors of cancer patients in the Northeast region of the U.S., and examines and explains the spatial variability of such behaviors across sub-regions.
(1) 46.8%, 85.5%, and 99.6% of cancer care received was within a driving time of 30, 60 and 180 minutes, respectively. (2) The exponential distance decay function is the best in capturing the travel behavior of cancer patients in the region and across most sub-regions. (3) The friction coefficient in the distance decay function is negatively correlated with the mean travel time. (4) The best-fitting function forms are associated with network structures. (5) The variation of the friction coefficient across sub-regions is related to factors such as urbanicity, economic development level, and market competition intensity.
The distance decay function offers an analytic metric to capture a full spectrum of travel behavior, and thus a more comprehensive measure than average travel time. Examining the geographic variation of travel behavior needs a reliable analysis unit such as organically defined "cancer service areas", which capture relevant health care market structure and thus are more meaningful than commonly-used geopolitical or census area units.
患者在利用医疗保健服务时的空间行为反映了他们的出行负担或移动性、医疗服务的可及性以及后续的治疗效果。本文推导了最拟合的距离衰减函数，以捕捉美国东北地区癌症患者的空间行为，并考察和解释这些行为在各子区域间的空间变异性。
（1）分别有46.8%、85.5%和99.6%的癌症护理是在30分钟、60分钟和180分钟的驾车时间内接受的。（2）指数距离衰减函数在捕捉该地区及大多数子区域癌症患者的出行行为方面表现最佳。（3）距离衰减函数中的摩擦系数与平均出行时间呈负相关。（4）最佳拟合函数形式与网络结构相关。（5）摩擦系数在各子区域间的变化与城市化程度、经济发展水平和市场竞争强度等因素有关。
距离衰减函数提供了一种分析指标，用以捕捉出行行为的全貌，因此比平均出行时间更具综合性。考察出行行为的地理差异需要一个可靠的分析单元，如有机定义的“癌症服务区”，其能反映相关医疗保健市场结构，因而比常用的地缘政治或人口普查区域单元更有意义。
