Cuervo Luis Gabriel, Villamizar Carmen Juliana, Osorio Lyda, Ospina María Beatriz, Cuervo Diana E, Cuervo Daniel, Bula María O, Zapata Pablo, Owens Nancy J, Hatcher-Roberts Janet, Martín Edith Alejandra, Piquero Felipe, Pinilla Luis Fernando, Martínez-Herrera Eliana, Jaramillo Ciro
Universitat Autònoma de Barcelona, Barcelona, Spain.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Lancet Reg Health Am. 2024 May 3;34:100752. doi: 10.1016/j.lana.2024.100752. eCollection 2024 Jun.
Many cities with traffic congestion lack accessibility assessments accounting for traffic congestion and equity considerations but have disaggregated georeferenced municipal-level open data on health services, populations, and travel times big data. We convened a multistakeholder intersectoral collaborative group that developed a digital, web-based platform integrating open and big data to derive dynamic spatial-temporal accessibility measurements (DSTAM) for haemodialysis services. We worked with stakeholders and data scientists and considered people's places of residence, service locations, and travel time to the service with the shortest travel time. Additionally, we predicted the impacts of strategically introducing haemodialysis services where they optimise accessibility.
Cross-sectional analyses of DSTAM, accounting for traffic congestion, were conducted using a web-based platform. This platform integrated traffic analysis zones, public census and health services datasets, and Google Distance Matrix API travel-time data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated improvements. Primary outcomes included the percentage of residents within a 20-min car drive of a haemodialysis service during peak and free-flow traffic congestion. Secondary outcomes focused on optimal locations to maximise accessibility with new services and potential improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. The study in Cali, Colombia, used geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for two weeks in 2020.
There were substantial traffic variations. Congestion reduced accessibility, especially among marginalised groups. For 6-12 July, free-flow and peak-traffic accessibility rates were 95.2% and 45.0%, respectively. For 23-29 November, free-flow and peak traffic accessibility rates were 89.1% and 69.7%. The locations where new services would optimise accessibility had slight variation and would notably enhance accessibility and health equity.
Establishing haemodialysis services in targeted areas has significant potential benefits. By increasing accessibility, it would enhance urban health and equity.
No external or institutional funding was received.
许多交通拥堵的城市缺乏考虑交通拥堵和公平性的可达性评估，但拥有关于医疗服务、人口和出行时间大数据的地理参考市级开放数据。我们召集了一个多利益相关方跨部门协作小组，该小组开发了一个基于网络的数字平台，整合开放数据和大数据，以得出血液透析服务的动态时空可达性测量值（DSTAM）。我们与利益相关者和数据科学家合作，考虑了人们的居住地点、服务地点以及前往耗时最短服务地点的出行时间。此外，我们预测了战略性引入血液透析服务对可达性优化的影响。
使用基于网络的平台对考虑交通拥堵的DSTAM进行横断面分析。该平台整合了交通分析区域、公共人口普查和医疗服务数据集以及谷歌距离矩阵应用程序编程接口出行时间数据。预测性和规范性分析确定了新血液透析服务的最佳位置并估计了改善情况。主要结果包括在高峰和自由流交通拥堵期间，居民在20分钟车程内可到达血液透析服务机构的百分比。次要结果集中在通过新服务实现可达性最大化的最佳位置以及潜在改善情况。研究结果按社会人口特征进行分类，提供了公平视角。哥伦比亚卡利的研究使用了2018年哥伦比亚调整后人口普查的地理和分类社会人口数据。获取了2020年两周的预测出行时间。
交通情况存在显著差异。拥堵降低了可达性，尤其是在边缘化群体中。7月6日至12日，自由流和高峰交通可达率分别为95.2%和45.0%。11月23日至29日，自由流和高峰交通可达率分别为89.1%和69.7%。新服务将优化可达性的位置略有不同，将显著提高可达性和健康公平性。
在目标区域建立血液透析服务具有显著的潜在益处。通过提高可达性，将改善城市健康和公平性。
未获得外部或机构资金。
