Using geographic information systems to understand health care access.

R L Phillips, E L Kinman, P G Schnitzer, E J Lindbloom, B Ewigman
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引用次数: 106

Abstract

Background: Determining a community's health care access needs and testing interventions to improve access are difficult. This challenge is compounded by the task of translating the relevant data into a format that is clear and persuasive to policymakers and funding agencies. Geographic information systems can analyze and transform complex data from various sources into maps that illustrate problems effortlessly for experts and nonexperts.

Objective: To combine the patient data of a community health center (CHC) with health care survey data to display the CHC service area, the community's health care access needs, and relationships among access, poverty, and political boundaries.

Design: Georeferencing, analyzing, and mapping information from 2 databases.

Setting: Boone County, Missouri.

Participants: Community health center patients and survey respondents.

Main outcome measures: Maps that define the CHC service area and patient demographics and show poor health care access in relation to the CHC service area, CHC utilization in relation to poverty, and rates of health care access by geopolitical region.

Results: The CHC serves a distinctly different area than originally targeted. Subpopulations with unmet health care access needs and poverty were identified by census tract. These underserved populations fell within geopolitical boundaries that were easily linked to their elected officials.

Conclusions: Geographic information systems are powerful tools for combining disparate data in a visual format to illustrate complex relationships that affect health care access. These systems can help evaluate interventions, inform health services research, and guide health care policy. Arch Fam Med. 2000;9:971-978

利用地理信息系统了解卫生保健的可及性。
背景:确定一个社区的卫生保健获取需求和测试干预措施以改善获取是困难的。将相关数据转换成一种对决策者和资助机构来说既清晰又有说服力的格式,这一任务使这一挑战更加复杂。地理信息系统可以分析并将各种来源的复杂数据转换成地图,为专家和非专家毫不费力地说明问题。目的:将某社区卫生服务中心患者数据与卫生保健调查数据相结合,揭示社区卫生服务中心服务区域、社区卫生保健可及性需求以及可及性、贫困和政治边界之间的关系。设计:从2个数据库中进行地理参考、分析和映射信息。环境:密苏里州布恩县。研究对象:社区卫生中心患者和调查对象。主要结果测量指标:定义CHC服务区和患者人口统计数据的地图,并显示与CHC服务区相关的卫生保健获取情况较差,与贫困相关的CHC利用率,以及按地缘政治区域划分的卫生保健获取率。结果:CHC作用的区域明显不同于最初的目标区域。按人口普查区确定了医疗保健需求未得到满足和贫困的亚人口。这些得不到充分服务的人口处于地缘政治边界之内,很容易与他们当选的官员联系在一起。结论:地理信息系统是一种强大的工具,可以将不同的数据以可视化格式组合在一起,说明影响医疗保健获取的复杂关系。这些系统可以帮助评估干预措施,为卫生服务研究提供信息,并指导卫生保健政策。中华医学杂志。2000;9:971-978
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