Swiss Health Observatory, Neuchâtel, Switzerland.
Health Place. 2023 Jan;79:102974. doi: 10.1016/j.healthplace.2023.102974. Epub 2023 Jan 26.
Good accessibility of health care services is essential to meet the needs of the population and ensure adequate health care coverage. It usually refers to two spatial dimensions: availability (competition between populations for the same medical supply) and reachability (distance between population and medical supply). Traditional indicators of health care accessibility usually fail to consider both of these components simultaneously. Floating-Catchment-Area (FCA) methods were developed to address these shortcomings. This study reviews the existing FCA methods and proposes the Modified Huff-based Variable 3 Steps Floating Catchment Area (MHV3SFCA) method as a new approach. The MHV3SFCA method integrates the strengths of several existing FCA methods into a single method, such as supply competition through the Huff model, and the integration of variable effective catchment sizes. In addition, and as a novelty, the MHV3SFCA relies on the assumption of a constant overall population demand, independent of the distances between population units and supply sites. It also accounts for absolute difference in distances without overestimating distance effects. Based on the results of a simulation study the paper discusses the strengths of the MHV3SFCA method capturing spatial differences in access to health care services.
医疗服务的良好可及性对于满足人口需求和确保充分的医疗保健覆盖至关重要。它通常指的是两个空间维度：可及性（人口对同一医疗供应的竞争）和可达性（人口与医疗供应之间的距离）。传统的医疗保健可及性指标通常未能同时考虑这两个组成部分。浮动集水区（FCA）方法就是为了解决这些缺点而开发的。本研究回顾了现有的 FCA 方法，并提出了基于改进的 Huff 模型的可变 3 步浮动集水区（MHV3SFCA）方法作为一种新方法。MHV3SFCA 方法将几种现有 FCA 方法的优势集成到一种方法中，例如通过 Huff 模型实现供应竞争，以及可变有效集水区大小的集成。此外，作为新颖之处，MHV3SFCA 方法基于人口总需求不变的假设，而不考虑人口单位和供应地点之间的距离。它还考虑了距离的绝对差异，而不会高估距离效应。基于模拟研究的结果，本文讨论了 MHV3SFCA 方法捕捉医疗服务获取空间差异的优势。
