Gravity models for potential spatial healthcare access measurement: a systematic methodological review
Abstract Background Quantifying spatial access to care—the interplay of accessibility and availability—is vital for healthcare planning and understanding implications of services (mal-)distribution. A plethora of methods aims to measure potential spatial access to healthcare services. The current st...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | International Journal of Health Geographics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12942-023-00358-z |
| _version_ | 1797414090800365568 |
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| author | Barbara Stacherl Odile Sauzet |
| author_facet | Barbara Stacherl Odile Sauzet |
| author_sort | Barbara Stacherl |
| collection | DOAJ |
| description | Abstract Background Quantifying spatial access to care—the interplay of accessibility and availability—is vital for healthcare planning and understanding implications of services (mal-)distribution. A plethora of methods aims to measure potential spatial access to healthcare services. The current study conducts a systematic review to identify and assess gravity model-type methods for spatial healthcare access measurement and to summarize the use of these measures in empirical research. Methods A two-step approach was used to identify (1) methodological studies that presented a novel gravity model for measuring spatial access to healthcare and (2) empirical studies that applied one of these methods in a healthcare context. The review was conducted according to the PRISMA guidelines. EMBASE, CINAHL, Web of Science, and Scopus were searched in the first step. Forward citation search was used in the second step. Results We identified 43 studies presenting a methodological development and 346 empirical application cases of those methods in 309 studies. Two major conceptual developments emerged: The Two-Step Floating Catchment Area (2SFCA) method and the Kernel Density (KD) method. Virtually all other methodological developments evolved from the 2SFCA method, forming the 2SFCA method family. Novel methodologies within the 2SFCA family introduced developments regarding distance decay within the catchment area, variable catchment area sizes, outcome unit, provider competition, local and global distance decay, subgroup-specific access, multiple transportation modes, and time-dependent access. Methodological developments aimed to either approximate reality, fit a specific context, or correct methodology. Empirical studies almost exclusively applied methods from the 2SFCA family while other gravity model types were applied rarely. Distance decay within catchment areas was frequently implemented in application studies, however, the initial 2SFCA method remains common in empirical research. Most empirical studies used the spatial access measure for descriptive purposes. Increasingly, gravity model measures also served as potential explanatory factor for health outcomes. Conclusions Gravity models for measuring potential spatial healthcare access are almost exclusively dominated by the family of 2SFCA methods—both for methodological developments and applications in empirical research. While methodological developments incorporate increasing methodological complexity, research practice largely applies gravity models with straightforward intuition and moderate data and computational requirements. |
| first_indexed | 2024-03-09T05:28:05Z |
| format | Article |
| id | doaj.art-2952768554d24340943a1f5fadc722ee |
| institution | Directory Open Access Journal |
| issn | 1476-072X |
| language | English |
| last_indexed | 2024-03-09T05:28:05Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Health Geographics |
| spelling | doaj.art-2952768554d24340943a1f5fadc722ee2023-12-03T12:34:55ZengBMCInternational Journal of Health Geographics1476-072X2023-12-0122112210.1186/s12942-023-00358-zGravity models for potential spatial healthcare access measurement: a systematic methodological reviewBarbara Stacherl0Odile Sauzet1Socio-Economic Panel (SOEP), German Institute for Economic Research (DIW Berlin)School of Public Health, Bielefeld UniversityAbstract Background Quantifying spatial access to care—the interplay of accessibility and availability—is vital for healthcare planning and understanding implications of services (mal-)distribution. A plethora of methods aims to measure potential spatial access to healthcare services. The current study conducts a systematic review to identify and assess gravity model-type methods for spatial healthcare access measurement and to summarize the use of these measures in empirical research. Methods A two-step approach was used to identify (1) methodological studies that presented a novel gravity model for measuring spatial access to healthcare and (2) empirical studies that applied one of these methods in a healthcare context. The review was conducted according to the PRISMA guidelines. EMBASE, CINAHL, Web of Science, and Scopus were searched in the first step. Forward citation search was used in the second step. Results We identified 43 studies presenting a methodological development and 346 empirical application cases of those methods in 309 studies. Two major conceptual developments emerged: The Two-Step Floating Catchment Area (2SFCA) method and the Kernel Density (KD) method. Virtually all other methodological developments evolved from the 2SFCA method, forming the 2SFCA method family. Novel methodologies within the 2SFCA family introduced developments regarding distance decay within the catchment area, variable catchment area sizes, outcome unit, provider competition, local and global distance decay, subgroup-specific access, multiple transportation modes, and time-dependent access. Methodological developments aimed to either approximate reality, fit a specific context, or correct methodology. Empirical studies almost exclusively applied methods from the 2SFCA family while other gravity model types were applied rarely. Distance decay within catchment areas was frequently implemented in application studies, however, the initial 2SFCA method remains common in empirical research. Most empirical studies used the spatial access measure for descriptive purposes. Increasingly, gravity model measures also served as potential explanatory factor for health outcomes. Conclusions Gravity models for measuring potential spatial healthcare access are almost exclusively dominated by the family of 2SFCA methods—both for methodological developments and applications in empirical research. While methodological developments incorporate increasing methodological complexity, research practice largely applies gravity models with straightforward intuition and moderate data and computational requirements.https://doi.org/10.1186/s12942-023-00358-zGravity models2SFCAKernel densityMethodological reviewPotential spatial accessHealthcare |
| spellingShingle | Barbara Stacherl Odile Sauzet Gravity models for potential spatial healthcare access measurement: a systematic methodological review International Journal of Health Geographics Gravity models 2SFCA Kernel density Methodological review Potential spatial access Healthcare |
| title | Gravity models for potential spatial healthcare access measurement: a systematic methodological review |
| title_full | Gravity models for potential spatial healthcare access measurement: a systematic methodological review |
| title_fullStr | Gravity models for potential spatial healthcare access measurement: a systematic methodological review |
| title_full_unstemmed | Gravity models for potential spatial healthcare access measurement: a systematic methodological review |
| title_short | Gravity models for potential spatial healthcare access measurement: a systematic methodological review |
| title_sort | gravity models for potential spatial healthcare access measurement a systematic methodological review |
| topic | Gravity models 2SFCA Kernel density Methodological review Potential spatial access Healthcare |
| url | https://doi.org/10.1186/s12942-023-00358-z |
| work_keys_str_mv | AT barbarastacherl gravitymodelsforpotentialspatialhealthcareaccessmeasurementasystematicmethodologicalreview AT odilesauzet gravitymodelsforpotentialspatialhealthcareaccessmeasurementasystematicmethodologicalreview |