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Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model

BACKGROUND: There are only limited studies on access to COVID-19 vaccines and identifying the most appropriate health centres for performing vaccination in metropolitan areas. This study aimed to measure potential spatial access to COVID-19 vaccination centres in Mashhad, the second-most populous ci...

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Autores principales: Mohammadi, Alireza, Mollalo, Abolfazl, Bergquist, Robert, Kiani, Behzad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443959/
https://www.ncbi.nlm.nih.gov/pubmed/34530923
http://dx.doi.org/10.1186/s40249-021-00904-6
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author Mohammadi, Alireza
Mollalo, Abolfazl
Bergquist, Robert
Kiani, Behzad
author_facet Mohammadi, Alireza
Mollalo, Abolfazl
Bergquist, Robert
Kiani, Behzad
author_sort Mohammadi, Alireza
collection PubMed
description BACKGROUND: There are only limited studies on access to COVID-19 vaccines and identifying the most appropriate health centres for performing vaccination in metropolitan areas. This study aimed to measure potential spatial access to COVID-19 vaccination centres in Mashhad, the second-most populous city in Iran. METHODS: The 2021 age structure of the urban census tracts was integrated into the enhanced two-step floating catchment area model to improve accuracy. The model was developed based on three different access scenarios: only public hospitals, only public healthcare centres and both (either hospitals or healthcare centres) as potential vaccination facilities. The weighted decision-matrix and analytic hierarchy process, based on four criteria (i.e. service area, accessibility index, capacity of vaccination centres and distance to main roads), were used to choose potential vaccination centres looking for the highest suitability for residents. Global Moran’s index (GMI) was used to measure the spatial autocorrelation of the accessibility index in different scenarios and the proposed model. RESULTS: There were 26 public hospitals and 271 public healthcare centres in the study area. Although the exclusive use of public healthcare centres for vaccination can provide the highest accessibility in the eastern and north-eastern parts of the study area, our findings indicate that including both public hospitals and public healthcare centres provide high accessibility to vaccination in central urban part. Therefore, a combination of public hospitals and public healthcare centres is recommended for efficient vaccination coverage. The value of GMI for the proposed model (accessibility to selected vaccination centres) was calculated as 0.53 (Z = 162.42, P < 0.01). Both GMI and Z-score values decreased in the proposed model, suggesting an enhancement in accessibility to COVID-19 vaccination services. CONCLUSIONS: The periphery and poor areas of the city had the least access to COVID-19 vaccination centres. Measuring spatial access to COVID-19 vaccination centres can provide valuable insights for urban public health decision-makers. Our model, coupled with geographical information systems, provides more efficient vaccination coverage by identifying the most suitable healthcare centres, which is of special importance when only few centres are available. GRAPHIC ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40249-021-00904-6.
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spelling pubmed-84439592021-09-16 Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model Mohammadi, Alireza Mollalo, Abolfazl Bergquist, Robert Kiani, Behzad Infect Dis Poverty Research Article BACKGROUND: There are only limited studies on access to COVID-19 vaccines and identifying the most appropriate health centres for performing vaccination in metropolitan areas. This study aimed to measure potential spatial access to COVID-19 vaccination centres in Mashhad, the second-most populous city in Iran. METHODS: The 2021 age structure of the urban census tracts was integrated into the enhanced two-step floating catchment area model to improve accuracy. The model was developed based on three different access scenarios: only public hospitals, only public healthcare centres and both (either hospitals or healthcare centres) as potential vaccination facilities. The weighted decision-matrix and analytic hierarchy process, based on four criteria (i.e. service area, accessibility index, capacity of vaccination centres and distance to main roads), were used to choose potential vaccination centres looking for the highest suitability for residents. Global Moran’s index (GMI) was used to measure the spatial autocorrelation of the accessibility index in different scenarios and the proposed model. RESULTS: There were 26 public hospitals and 271 public healthcare centres in the study area. Although the exclusive use of public healthcare centres for vaccination can provide the highest accessibility in the eastern and north-eastern parts of the study area, our findings indicate that including both public hospitals and public healthcare centres provide high accessibility to vaccination in central urban part. Therefore, a combination of public hospitals and public healthcare centres is recommended for efficient vaccination coverage. The value of GMI for the proposed model (accessibility to selected vaccination centres) was calculated as 0.53 (Z = 162.42, P < 0.01). Both GMI and Z-score values decreased in the proposed model, suggesting an enhancement in accessibility to COVID-19 vaccination services. CONCLUSIONS: The periphery and poor areas of the city had the least access to COVID-19 vaccination centres. Measuring spatial access to COVID-19 vaccination centres can provide valuable insights for urban public health decision-makers. Our model, coupled with geographical information systems, provides more efficient vaccination coverage by identifying the most suitable healthcare centres, which is of special importance when only few centres are available. GRAPHIC ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40249-021-00904-6. BioMed Central 2021-09-16 /pmc/articles/PMC8443959/ /pubmed/34530923 http://dx.doi.org/10.1186/s40249-021-00904-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Mohammadi, Alireza
Mollalo, Abolfazl
Bergquist, Robert
Kiani, Behzad
Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title_full Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title_fullStr Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title_full_unstemmed Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title_short Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
title_sort measuring covid-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443959/
https://www.ncbi.nlm.nih.gov/pubmed/34530923
http://dx.doi.org/10.1186/s40249-021-00904-6
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