title: Minimizing Spatial Variability of Healthcare Spatial Accessibility-The Case of a Dengue Fever Outbreak.
abstract: Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply and demand information. In this study, we proposed an optimal model with the three-step floating catchment area (3SFCA) to account for the supply to minimize variability in spatial accessibility. We used empirical dengue fever outbreak data in Tainan City, Taiwan in 2015 to demonstrate the dynamic change in spatial accessibility based on the epidemic trend. The x and y coordinates of dengue-infected patients with precision loss were provided publicly by the Tainan City government, and were used as our model's demand. The spatial accessibility of heath care during the dengue outbreak from August to October 2015 was analyzed spatially and temporally by producing accessibility maps, and conducting capacity change analysis. This study also utilized the particle swarm optimization (PSO) model to decrease the spatial variation in accessibility and shortage areas of healthcare resources as the epidemic went on. The proposed method in this study can help decision makers reallocate healthcare resources spatially when the ratios of demand and supply surge too quickly and form clusters in some locations.
authors.affiliation: Department of Geomatics, National Cheng Kung University, Tainan City 700, Taiwan. honejay@mail.ncku.edu.tw.
authors.forename: Hone-Jay
authors.initials: HJ
authors.lastname: Chu
authors.affiliation: Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City 115, Taiwan. bclin@gate.sinica.edu.tw.
authors.forename: Bo-Cheng
authors.initials: BC
authors.lastname: Lin
authors.affiliation: Department of Geomatics, National Cheng Kung University, Tainan City 700, Taiwan. yudaniel178@yahoo.com.tw.
authors.forename: Ming-Run
authors.initials: MR
authors.lastname: Yu
authors.affiliation: Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City 115, Taiwan. tachien@gate.sinica.edu.tw.
authors.forename: Ta-Chien
authors.initials: TC
authors.lastname: Chan
mesh_terms: D001185:Artificial Intelligence; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D003198:Computer Simulation; D003657:Decision Making; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D015276:Health Care Rationing / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D009111:Local Government; D008962:Models, Theoretical; D062206:Spatial Analysis; D013624:Taiwan / Q000453:epidemiology
keywords: floating catchment area; particle swarm optimization