Improving Accessibility to Radiotherapy Services in Cali, Colombia : Cross-Sectional Equity Analyses Using Open Data and Big Data Travel Times from 2020
Cuervo, L.G (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Villamizar, Carmen Juliana (Johns Hopkins Bloomberg School of Public Health, Wolfe Street Building, Baltimore, USA)
Cuervo, Daniel (IQuartil SAS, Colombia)
Zapata Murillo, Pablo (IQuartil SAS, Colombia)
Ospina, Maria B. (Queen's University, Kingston (ON), Canada)
Valencia, Sara Marcela (Universidad Nacional de Colombia)
Polo, Alfredo (Technical Cooperation and Capacity Development, Madrid)
Suárez, Ángela (Johns Hopkins Bloomberg School of Public Health, Wolfe Street Building, Baltimore, USA)
Bula, Maria (Independent researcher, Bogotá, Colombia)
Miranda, Jaime (University of Sydney, Austràlia)
Millán, Gynna (School of Civil and Geomatic Engineering of the Universidad del Valle, Colombia)
Cuervo, Diana Elizabeth (Junta Nacional de Calificación de Invalidez [National Disability Board of Colombia)
Owens, Nancy J. (Independent content and communications consultant, Fairfax, USA)
Piquero Villegas, Felipe (Patient advocate and author of an autopathography, Bogotá, Colombia)
Hatcher-Roberts, Janet (University of Ottawa, Ottawa, Canada)
Paredes, Gabriel Dario (Independent consultant on emergency medicine and humanitarian response, Bogotá, Colombia)
Navarro, Maria Fernanda (Regional Director, City Cancer Challenge Foundation, Bogotá, Colombia)
Minotta, Ingrid Liliana (ProPacífico, Cali, Colombia)
Palta, Carmen (ProPacífico, Cali, Colombia)
Martínez Herrera, Eliana (Universidad de Antioquia, Colombia)
Jaramillo, Ciro (School of Civil and Geomatic Engineering of the Universidad del Valle, Colombia)

Data:	2024
Resum:	In this study, we employed a methodology to evaluate and forecast the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion from an equity perspective. Furthermore, we identified 1-2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through design thinking. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to search heuristics to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions at hourly assessments for 6-12 July 2020 and 23-29 November 2020. The interactive digital platform is openly available. Primary and Secondary Outcomes: We present descriptive statistics and population distribution heatmaps based on 20-minute Accessible Catchment Area (ACO) isochrones for car journeys. These isochrones connect the population-weighed centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions, ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1-2 optimal locations where new services would maximise the 20-minute ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-minute ACO by car dropped from 91% during free-flow traffic to 31% during peak traffic for the week of 6-12 July 2020. Specific ethnic groups, individuals with lower educational attainment, and residents in the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1-2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors.
Drets:	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.
Llengua:	Anglès
Document:	Prepublicació ; recerca ; Versió de l'autor

DOI: 10.2139/ssrn.4722439

40 p, 3.3 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats