Dynamic accessibility by car to tertiary care emergency services in Cali, Colombia, in 2020 : cross-sectional equity analyses using travel time big data from a Google API
Cuervo, L.G (Universitat Autònoma de Barcelona)
Martinez Herrera, Eliana (Universidad de Antioquia)
Osorio, Lyda (Universidad del Valle)
Hatcher Roberts, Janet (Brùyere Research Institute and Adjunct School of Epidemiology and Public Health, University of Ottawa)
Cuervo, Daniel (Iquartil SAS)
Bula, Maria Olga (Egis Consulting)
Pinilla, Luis Fernando (Universidad de la Sabana)
Piquero, Felipe
Jaramillo, Ciro (School of Civil and Geomatic Engineering, Universidad del Valle, Colombia)

Additional title:	Cross-sectional equity analysis of accessibility by automobile to tertiary care emergency services in Cali, Colombia in 2020
Date:	2022
Abstract:	Objectives: To test a new approach to characterise accessibility to tertiary care emergency health services in urban Cali and assess the links between accessibility and sociodemographic factors relevant to health equity. Design: The impact of traffic congestion on accessibility to tertiary care emergency departments was studied with an equity perspective, using a web-based digital platform that integrated publicly available digital data, including sociodemographic characteristics of the population and places of residence with travel times. Setting and participants: Cali, Colombia (population 2. 258million in 2020) using geographic and sociodemographic data. The study used predicted travel times downloaded for a week in July 2020 and a week in November 2020. Primary and secondary outcomes: The share of the population within a 15min journey by car from the place of residence to the tertiary care emergency department with the shortest journey (ie, 15min accessibility rate (15mAR)) at peak-traffic congestion hours. Sociodemographic characteristics were disaggregated for equity analyses. A time-series bivariate analysis explored accessibility rates versus housing stratification. Results: Traffic congestion sharply reduces accessibility to tertiary emergency care (eg, 15mAR was 36. 8% during peak-traffic hours vs 84. 4% during free-flow hours for the week of 6-12 July 2020). Traffic congestion sharply reduces accessibility to tertiary emergency care. The greatest impact fell on specific ethnic groups, people with less educational attainment and those living in low-income households or on the periphery of Cali (15mAR: 8. 1% peak traffic vs 51% free-flow traffic). These populations face longer average travel times to health services than the average population. Conclusions: These findings suggest that health services and land use planning should prioritise travel times over travel distance and integrate them into urban planning. Existing technology and data can reveal inequities by integrating sociodemographic data with accurate travel times to health services estimates, providing the basis for valuable indicators.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; Versió de l'autor
Published in:	BMJ open, Vol 12 (2022) , ISSN 2044-6055

DOI: 10.1136/bmjopen-2022-062178
DOI: 10.1101/2022.02.03.22269929
PMID: 36581989

Article 18 p, 5.6 MB

Preprint 25 p, 2.1 MB

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