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Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia
BACKGROUND: No existing measures of HIV care access consider both spatial proximity to services and provider-related characteristics in a single measure. We developed and applied a tool to: (1) quantify spatial access to HIV care services (supply) and (2) identify underserved areas with respect to H...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932000/ https://www.ncbi.nlm.nih.gov/pubmed/27429893 http://dx.doi.org/10.1186/s40064-016-2515-8 |
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author | Dasgupta, Sharoda Kramer, Michael R. Rosenberg, Eli S. Sanchez, Travis H. Sullivan, Patrick S. |
author_facet | Dasgupta, Sharoda Kramer, Michael R. Rosenberg, Eli S. Sanchez, Travis H. Sullivan, Patrick S. |
author_sort | Dasgupta, Sharoda |
collection | PubMed |
description | BACKGROUND: No existing measures of HIV care access consider both spatial proximity to services and provider-related characteristics in a single measure. We developed and applied a tool to: (1) quantify spatial access to HIV care services (supply) and (2) identify underserved areas with respect to HIV cases (demand), by travel mode, in Atlanta. METHODS: Building on a study of HIV care engagement, data from an HIV care provider database, and HIV case counts by zip code tabulation area (ZCTA) from AIDSVu.org, we fit a discrete choice model to estimate practice characteristics most salient in defining patient care access. Modified spatial gravity modeling quantified supply access based on discrete choice model results separately for travel by car and by public transportation. Relative access scores were calculated by ZCTA, and underserved areas (defined as having low supply access and high HIV case count) were identified for each travel mode. RESULTS: Characteristics retained in the final model included: travel distance, available provider-hours, availability of ancillary services, and whether Ryan White patients were accepted. HIV provider supply was higher in urban versus suburban/rural areas for both travel modes, with lower supply access if traveling by public transportation. Underserved areas were concentrated in south and east Atlanta if traveling by public transportation, overlapping with many areas of high poverty. Approximately 7.7 %, if traveling by car, and 64.3 %, if traveling by public transportation, of Atlanta-based persons with diagnosed HIV infection resided in underserved areas. CONCLUSION: These findings highlight underserved areas in south and east Atlanta if traveling by public transit. Conceptualizing access to medical services spatially and by travel mode may help bridge gaps between patient needs and service availability and improve HIV outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40064-016-2515-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4932000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-49320002016-07-16 Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia Dasgupta, Sharoda Kramer, Michael R. Rosenberg, Eli S. Sanchez, Travis H. Sullivan, Patrick S. Springerplus Research BACKGROUND: No existing measures of HIV care access consider both spatial proximity to services and provider-related characteristics in a single measure. We developed and applied a tool to: (1) quantify spatial access to HIV care services (supply) and (2) identify underserved areas with respect to HIV cases (demand), by travel mode, in Atlanta. METHODS: Building on a study of HIV care engagement, data from an HIV care provider database, and HIV case counts by zip code tabulation area (ZCTA) from AIDSVu.org, we fit a discrete choice model to estimate practice characteristics most salient in defining patient care access. Modified spatial gravity modeling quantified supply access based on discrete choice model results separately for travel by car and by public transportation. Relative access scores were calculated by ZCTA, and underserved areas (defined as having low supply access and high HIV case count) were identified for each travel mode. RESULTS: Characteristics retained in the final model included: travel distance, available provider-hours, availability of ancillary services, and whether Ryan White patients were accepted. HIV provider supply was higher in urban versus suburban/rural areas for both travel modes, with lower supply access if traveling by public transportation. Underserved areas were concentrated in south and east Atlanta if traveling by public transportation, overlapping with many areas of high poverty. Approximately 7.7 %, if traveling by car, and 64.3 %, if traveling by public transportation, of Atlanta-based persons with diagnosed HIV infection resided in underserved areas. CONCLUSION: These findings highlight underserved areas in south and east Atlanta if traveling by public transit. Conceptualizing access to medical services spatially and by travel mode may help bridge gaps between patient needs and service availability and improve HIV outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40064-016-2515-8) contains supplementary material, which is available to authorized users. Springer International Publishing 2016-07-04 /pmc/articles/PMC4932000/ /pubmed/27429893 http://dx.doi.org/10.1186/s40064-016-2515-8 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Dasgupta, Sharoda Kramer, Michael R. Rosenberg, Eli S. Sanchez, Travis H. Sullivan, Patrick S. Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title | Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title_full | Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title_fullStr | Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title_full_unstemmed | Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title_short | Development of a comprehensive measure of spatial access to HIV provider services, with application to Atlanta, Georgia |
title_sort | development of a comprehensive measure of spatial access to hiv provider services, with application to atlanta, georgia |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932000/ https://www.ncbi.nlm.nih.gov/pubmed/27429893 http://dx.doi.org/10.1186/s40064-016-2515-8 |
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