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初级医疗保健与兽医护理服务提供者的可及性关联:空间引力模型的新应用

Correlating Access to Primary Medical Care and Veterinary Care Providers: A Novel Application of Spatial Gravity Modelling.

作者信息

Neal Sue M

机构信息

Department of Political Science, Arkansas State University, Jonesboro, AR 72467, USA.

Veterinary Care Accessibility Project, Rochester, MI 48306, USA.

出版信息

Vet Sci. 2023 Sep 11;10(9):565. doi: 10.3390/vetsci10090565.

Abstract

Increasingly, health professionals are recognizing the need for a more holistic, or One Health, approach to wellness. Companion animals share the lives and homes of many Americans, and yet little research exists on the intersection of disparities of access to veterinary care and access to human health care. This research aims to fill that gap by exploring the use of a spatial model that identifies the relationship of supply and demand while also considering reductions as a function of travel time to a care facility. Four counties in Alabama were analyzed at the census tract level to determine the supply of primary care physicians and veterinary care providers. This research provides a unique application of the Enhanced Two-Step Floating Catchment Area model by independently examining access to each type of care and then comparing both access supply values at the census level. Results indicated a statistically significant positive relationship between access to both types of care, implying areas with lower access to primary care have concomitantly low access to veterinary care. Implications for practice include the introduction of this methodological approach, identification of future parameter specification research to improve the approach, and identification of an area of significant concern in the One Health framework. Further, the results can inform solution strategies such as offering integrated care interventions for both humans and their companion animal household members with direct use for policymakers aimed at increasing equitable access to health care across the One Health spectrum.

摘要

越来越多的健康专业人士认识到,需要一种更全面的,即“同一健康”的方法来促进健康。伴侣动物与许多美国人共同生活在家庭中,但关于获得兽医护理的差异与获得人类医疗保健的差异之间的交叉研究却很少。本研究旨在通过探索一种空间模型的应用来填补这一空白,该模型可识别供需关系,同时将减少量视为到护理机构的出行时间的函数。在阿拉巴马州的四个县,以普查区为单位进行分析,以确定初级保健医生和兽医护理提供者的供应情况。本研究通过独立检查每种护理类型的可及性,然后在普查层面比较两种可及性供应值,对增强型两步浮动集水区模型进行了独特的应用。结果表明,两种护理类型的可及性之间存在统计学上显著的正相关关系,这意味着初级保健可及性较低的地区,兽医护理的可及性也较低。对实践的启示包括引入这种方法,确定未来改进该方法的参数规范研究,以及确定“同一健康”框架中一个重大关注领域。此外,研究结果可为解决方案策略提供参考,例如为人类及其伴侣动物家庭成员提供综合护理干预措施,这可直接供政策制定者使用,旨在增加“同一健康”范围内医疗保健的公平可及性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2062/10534788/aefcc3c8a8ac/vetsci-10-00565-g001.jpg

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