The effect of concentrating obstetrics services in fewer hospitals on patient access: a simulation

International Journal of Health Geographics
Soichi KoikeHideo Yasunaga

Abstract

In Japan, the number of obstetrics facilities has steadily decreased and the selection and concentration of obstetrics facilities is progressing rapidly. Obstetrics services should be concentrated in fewer hospitals to improve quality of care and reduce the workload of obstetricians. However, the impact of this intensification of services on access to obstetrics hospitals is not known. We undertook a simulation to examine how the intensification of obstetrics services would affect access to hospitals based on a variety of scenarios, and the implications for health policy. The female population aged between 15 and 49 living within a 30-min drive of an obstetrics hospital was calculated using a Geographic Information System for three possible intensification scenarios: Scenario 1 retained facilities with a higher volume of deliveries without considering the geographic boundaries of Medical Service Areas (MSAs, zones of healthcare administration and management); Scenario 2 prioritized retaining at least one hospital in each MSA and then retained higher delivery volume institutions, while Scenario 3 retained facilities to maximize population coverage using location-allocation modeling. We also assessed the impact of concentrating s...Continue Reading

References

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Citations

Jul 29, 2016·International Journal of Health Geographics·Henrikki TenkanenTuuli Toivonen
Sep 3, 2019·Bulletin of the World Health Organization·Yuto MaedaAndy Crump
Sep 12, 2020·Environmental Health and Preventive Medicine·Satoshi ToyokawaShigeru Ueda
May 7, 2019·The Journal of Obstetrics and Gynaecology Research·Hiroshi Kobayashi, Toshiyuki Sado

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Methods Mentioned

BETA
cesarean section

Software Mentioned

ArcGIS Network Analyst extension
SPSS
MarketPlanner GIS
ArcGIS
GIS
ColorBrewer
Stata

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