| Introduction: Unfair distribution of healthcare services is one of the most important issues all over the world. The present study aimed to determine the distribution pattern of available hospital beds and the accessibility pattern to hospitals in Shiraz.Methods: This was an analytical study. At first, spatial distribution pattern of available hospital beds was determined using Moran’s Index (Moran’s I). Then, the accessibility pattern to hospitals was determined using Euclidean distance and network travel distance metrics. Allof the analyses were conducted using Arc GIS (10.3) software.Results: The results revealed that available hospital beds had a random and unbalanced distribution pattern in Shiraz based on Moran’s I (Moran’s I=-0.05). Besides, according the achieved standard service areas for the existing hospitals, calculated by using Network analysis tools, 65.47% of Shiraz population was underserved in terms of accessibility. Furthermore, assessment of accessibility patterns resulted from both types of applied distances, indicating that in most cases hospitals were located in the central parts of the city.Conclusion: According to the results of the present study, distribution of hospitals in Shiraz was unfair. Therefore, policymakers are suggested to plan in order to increase the number of Shiraz hospitals. They are also recommended that they should give priority to establishing new hospitals in areas without standard accessibility over areas with standard accessibility based on the results of the present study.Keywords: Accessibility, Available bed, Hospital, Moran’s index, Network analysis, Spatial pattern |
- Dahlgren G, Whitehead M. Concepts and
- Principles for Tackling Social Inequities in
- Health: Levelling Up. København: WHO
- Regional Office for Europe; 2006.
- Culyer AJ, Wagstaff A. Equity and equality
- in health and health care. J Health Econ.
- ;12(4):431-57. doi: 10.1186/1475-9276-10-37
- Brabyn L, Skelly C. Modeling population access
- to New Zealand public hospitals. International
- journal of health geographics. 2002;1(1):3.
- Brabyn L, Skelly C. Modeling population access
- to New Zealand public hospitals. International
- journal of health geographics. 2002;1(1):3.
- Love D, Lindquist P. The geographical accessibility
- of hospitals to the aged: a geographic information
- systems analysis within Illinois. Health Serv Res.
- ;29(6):629-51.
- Rice N, Smith PC. Ethics and geographical equity
- in health care. J Med Ethics. 2001;27(4):256-61.
- doi: 10.1136/jme.27.4.256.
- McLafferty SL. GIS and health care. Annu Rev
- Public Health. 2003;24:25-42. doi: 10.1146/
- annurev.publhealth.24.012902.141012
- Clark R, Coffee N. Why measuring accessibility
- is important for public health: a review from the
- Cardiac ARIA project. Public Health Bulletin of
- South Australia. 2011;8(1):3-8.
- Dever GA, Champagne F. Epidemiology in health
- services management: Jones & Bartlett Learning;
- Apparicio P, Abdelmajid M, Riva M, Shearmur R.
- Comparing alternative approaches to measuring
- the geographical accessibility of urban health
- services: Distance types and aggregation-error
- issues. International journal of health geographics.
- ;7:7. doi: 10.1186/1476-072X-7-7
- Rosero-Bixby L. Spatial access to health care in
- Costa Rica and its equity: a GIS-based study. Soc
- Sci Med. 2004;58(7):1271-84. doi: 10.1016/S0277-
- (03)00322-8
- Kalogirou S, Mostratos N, editors. Geographical
- Acces to Health: modelling population access
- to Greek public hospitals. 7th Panhellenic
- Geografical Conference of the Hellenic
- Geographical Society Physical Geography and
- the Environment-Sustainable Development and
- Planning; 2004: HGS Mytilene, Greece.
- Pedigo AS, Odoi A. Investigation of disparities in
- geographic accessibility to emergency stroke and
- myocardial infarction care in East tennessee using
- geographic information systems and network
- analysis. Ann Epidemiol. 2010;20(12):924-30. doi:
- 1016/j.annepidem.2010.06.013
- Shahid R, Bertazzon S, Knudtson ML, Ghali
- WA. Comparison of distance measures in
- spatial analytical modeling for health service
- planning. BMC Health Serv Res. 2009;9:200. doi:
- 1186/1472-6963-9-200
- Boscoe FP, Henry KA, Zdeb MS. A Nationwide
- Comparison of Driving Distance Versus Straight-
- Line Distance to Hospitals. The Professional
- geographer : the journal of the Association
- of American Geographers. 2012;64(2). doi:
- 1080/00330124.2011.583586
- Deza MM, Deza E. Encyclopedia of distances.
- Encyclopedia of Distances: Springer; 2009. p.
- -583.
- Comber A, Brunsdon C, Green E. Using a GISbased
- network analysis to determine urban
- greenspace accessibility for different ethnic and
- religious groups. Landscape and Urban Planning.
- ;86(1):103-14.
- Kumar P, Kumar D. Network analysis using
- GIS techniques: A case of Chandigarh city.
- International Journal of Science and Research.
- ;5(2):409-11.
- Moran PA. Notes on continuous stochastic
- phenomena. Biometrika. 1950;37(1-2):17-23. doi:
- 2307/2332142.
- Li H, Calder CA, Cressie N. Beyond Moranâs
- I: testing for spatial dependence based on the
- spatial autoregressive model. Geographical
- Analysis. 2007;39(4):357-75. doi: 10.1111/j.1538-
- 2007.00708.x
- Panigrahi N. Computing in geographic
- information systems. Florida: CRC Press; 2014.
- Maciejewski R. Data representations,
- transformations, and statistics for visual reasoning.
- Synthesis Lectures on Visualization. 2011;2(1):1-
- doi: 10.2200/s00357ed1v01y201105vis002.
- Nazaripour H, Dostkamiyan M, Alizadeh S.
- The spatial distribution patterns of temperature,
- precipitation, and humidity using geostatistical
- exploratory analysis (case study: Central Area
- of Iran). Journal of Earth and Space Physics.
- ;41(1):99-117. Persion.
- McKee M, Healy J. The role of the hospital in a
- changing environment. Bull World Health Organ.
- ;78(6):803-10.
- Rahimi F, Goli A, Rezaee R. Hospital locationallocation
- in Shiraz using Geographical
- Information System (GIS). Shiraz E Med J.
- ;18(8). doi: 10.5812/semj.57572.
- Mizen A, Fry R, Grinnell D, Rodgers SE.
- Quantifying the Error Associated with
- Alternative GIS-based Techniques to Measure
- Access to Health Care Services. AIMS
- public health. 2015;2(4):746-61. doi: 10.3934/
- publichealth.2015.4.746.
- Satcher D, Rust G. Achieving health equity in
- America. Ethn Dis. 2006;16(2 Suppl 3):S3-8-13.
- Beedasy J. Rural designations and geographic
- access to tertiary healthcare in Idaho. Online J
- Rural Res Policy. 2010;5(2):1. doi: 10.4148/ojrrp.
- v5i2.191.
- Kreng VB, Yang CT. The equality of resource
- allocation in health care under the National
- Health Insurance System in Taiwan. Health
- Policy. 2011;100(2-3):203-10. doi: 10.1016/j.
- healthpol.2010.08.003.
- Kumar N. Changing geographic access to and
- locational efficiency of health services in two
- Indian districts between 1981 and 1996. Soc
- Sci Med. 2004;58(10):2045-67. doi: 10.1016/j.
- socscimed.2003.08.019.
- Balarajan Y, Selvaraj S, Subramanian SV. Health
- care and equity in India. Lancet. 2011;377(9764):505-
- doi: 10.1016/S0140-6736(10)61894-6.
- Masseria C, Giannoni M. Equity in access to
- health care in Italy: a disease-based approach. Eur
- J Public Health. 2010;20(5):504-10. doi: 10.1093/
- eurpub/ckq029.
- Barraza-Llorens M, Bertozzi S, Gonzalez-Pier E,
- Gutierrez JP. Addressing inequity in health and
- health care in Mexico. Health Aff (Millwood).
- ;21(3):47-56. doi: 10.1377/hlthaff.21.3.47.
- Gutierrez JP, Garcia-Saiso S, Dolci GF, Hernandez
- Avila M. Effective access to health care in
- Mexico. BMC Health Serv Res. 2014;14:186. doi:
- 1186/1472-6963-14-186.
- Liu GG, Zhao Z, Cai R, Yamada T, Yamada T.
- Equity in health care access to: assessing the
- urban health insurance reform in China. Soc Sci
- Med. 2002;55(10):1779-94. doi: 10.1016/s0277-
- (01)00306-9.
- Liu W, Liu Y, Twum P, Li S. National equity of
- health resource allocation in China: data from
- to 2013. Int J Equity Health. 2016;15:68. doi:
- 1186/s12939-016-0357-1.
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