Assessing equity in accessibility to haemodialysis services by automobile in Cali, Colombia : Cross-sectional analyses using publicly available data
Cuervo, Luis Gabriel (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Villamizar Jaimes, Carmen Juliana (Johns Hopkins Bloomberg School of Public Health)
Osorio, Lyda (Universidad del Valle (Colòmbia))
Ospina, Maria Beatriz (Faculty of Health Sciences, Queen's University)
Cuervo, Diana E. (National Disability Board of Colombia)
Cuervo, Daniel (IQuartil SAS)
Bula, Maria Olga
Zapata Murillo, Pablo
Owens, Nancy J.
Hatcher-Roberts, Janet (Bruyère Research Institute, University of Ottawa)
Martin, Edith Alejandra (Colombian Association of Transplanted Athletes)
Piquero Villegas, Felipe
Pinilla, Luis Fernando (Universidad de la Sabana, Colombia)
Martínez Herrera, Elinan (National Faculty of Public Health, Universidad de Antioquia, Medellín)
Jaramillo, Ciro (School of Civil and Geomatic Engineering of the Universidad del Valle, Cali)

Fecha:	2023
Resumen:	Objectives: To obtain dynamic spatial-temporal measurements of driving times to haemodialysis services and estimate the benefits of adding new services. Design: Cross-sectional analyses of dynamic spatial-temporal accessibility, considering traffic congestion. A web-based platform integrated traffic analysis zones, public census and health services datasets, with Google Distance Matrix API big travel-time big data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated accessibility improvements. Setting and participants: Cali, Colombia (2020 population: 2. 258 million) using geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for 6-12 July and 23-29 November 2020. This study is part of a project measuring accessibility to health services. Primary and secondary outcomes: Percentage of residents within 20 minutes by car of a haemodialysis service at peak- and free-flow traffic congestion. Locations where new services maximise accessibility and estimated improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. Results: Accessibility was lower in July, without COVID-19 traffic restrictions. Traffic congestion reduces accessibility to haemodialysis, hurting more less-educated people, residents of low-income housing and outlying neighbourhoods, and specific ethnic groups. For 6-12 July, free-flow and peak-traffic accessibility were 95. 2% and 45. 0%, respectively; 19. 9% at peak traffic for the lowest-income stratum. Adding services in the Agua Blanca district and southern Cali would increase peak traffic accessibility to 70. 2% and 62. 4% for the lowest-income stratum. Accessibility for 23-29 November was better. Conclusions: New haemodialysis services in eastern Cali would improve accessibility and reduce inequities. Dynamic accessibility measures improve health services and land-use planning.
Derechos:	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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Health Services Accessibility ; City Planning ; Urban Health ; Health inequality monitoring ; Spatial analysis ; Residence characteristics ; Spatial distribution population ; Accessibility Health Services ; Health Services Geographic Accessibility ; Health Services Research ; Renal Dialysis ; Kidney Failure
Publicado en:	SSRN, March 2023, p. 4299562

DOI: 10.2139/ssrn.4299562

29 p, 2.8 MB

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