ArticleBMC health services research2021
Measuring hospital spatial accessibility using the enhanced two-step floating catchment area method to assess the impact of spatial accessibility to hospital and non-hospital care on the length of hospital stay.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Optimizing mobile mammography deployment in Oklahoma 2024: a two-step floating catchment area approach.Geospatial health · 2026Article
- Comparing disparities in geographic proximity to exercise-based cardiac rehabilitation before and after decentralisation of services: a repeated cross-sectional study using individual-level register data.International journal for equity in health · 2025Article
- Spatial accessibility for deploying mobile lung cancer screenings in a rural state using two-step floating catchment spatial analysis in Oklahoma, United States 2025.Preventive medicine reports · 2025Article
- Spatial Analysis of Travel Distances for Persons with Common Cancers Seeking Care at a Tertiary Care Facility in South India: An Operational Research.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Spatial accessibility modeling to healthcare facilities in the case of health shocks of Midnapore municipality, India.GeoJournal · 2023Article
- Disparities in Spatial Access to Emergency Surgical Services in the US.JAMA health forum · 2022Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOptimal healthcare access improves the health status and decreases health inequalities. Many studies demonstrated the importance of spatial access to healthcare facilities in health outcomes, particularly using the enhanced two-step floating catchment area (E2SFCA) method. The study objectives were to build a hospital facility access indicator at a fine geographic scale, and then to assess the impact of spatial accessibility to inpatient hospital and non-hospital care services on the length of hospital stay (LOS).
methodsData concerning older adults (≥75 years) living in the Nord administrative region of France were used. Hospital spatial accessibility was computed with the E2SFCA method, and the LOS score was calculated from the French national hospital activity and patient discharge database. The relationship between LOS and spatial accessibility to inpatient hospital care and to three non-hospital care types (general practitioners, physiotherapists, and home-visiting nurses) was analyzed with linear regression models.
resultsThe mean number (standard deviation) of beds per 10,000 inhabitants was 19.0 (10.69) in Medical, Surgical and Obstetrics (MCO) facilities and 5.58 (2.19) in Postoperative and Rehabilitation Care (SSR) facilities, highlighting important variations within the region. Accessibility to hospital services was higher in large urban areas, despite the dense population and higher demand. In 2014, the mean LOS scores were 0.26 for MCO and 0.85 for SSR, but their geographical repartition was non-homogeneous. The linear regression analysis revealed a strong negative and significant association between LOS and non-hospital care accessibility.
conclusionsThis is the first study to measure spatial accessibility to inpatient hospital care in France using the E2SFCA method, and to investigate the relationship between healthcare utilization (LOS score) and spatial accessibility to inpatient hospital care facilities and three types of non-hospital care services. Our findings might help to make decisions about deploying additional beds and to identify the best locations for non-hospital care services. They might also contribute to improve access, and to ensure the best coordination and sustainability of inpatient and outpatient services, in order to better cover the population's healthcare needs. International studies using multiple consensual indicators of healthcare outcomes and accessibility and sophisticated modeling methods are needed.
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