Does Health Service Funding Go Where the Need Is? A Prototype Spatial Access Analysis for New Urban Contracts Data
| Autor: | Nicole P. Marwell, Julia Koschinsky, Raed Mansour |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Service (business)
Spatial decision support system medicine.medical_specialty Government Spatial Analysis Public health Health Policy Contracts Health Services Accessibility Health services Spatial access Administrative contracts data Residence Characteristics Container (abstract data type) medicine Humans Business Marketing Public aspects of medicine RA1-1270 Human services Health department Research Article |
| Zdroj: | BMC Health Services Research, Vol 22, Iss 1, Pp 1-12 (2022) BMC Health Services Research |
| ISSN: | 1556-5068 |
| DOI: | 10.2139/ssrn.3832293 |
| Popis: | Background Much of spatial access research measures the proximity to health service locations. We advance this research by focusing on whether health service funding is within walkable reach of neighborhoods with high hardship. This is made possible by a new administrative data source: financial contracts data for those human services that are delivered by nonprofits under contract with the government. Methods In a prototypical spatial access study we apply a classic 2-step floating area catchment model for walkable network access to analyze 2018 data about contracted nonprofit health services funded by the Chicago Department of Public Health (CDPH). CDPH collected the data for the purpose of this study. Results We find that the common container approach of aggregating contract amounts by provider headquarter locations in a given area (ignoring satellite service sites) underestimates the share of funding that goes to Chicago neighborhoods with higher hardship. Once service sites and spatial access are taken into account, a larger share of CDPH funds was found to be within walkable reach of Chicago’s high hardship areas. This was followed by low hardship areas (which could be driven by more headquarter locations there that do serve areas throughout the city). Medium hardship areas trail both, perhaps warranting closer attention. We explore these results by program type and neighborhood with a spatial decision support system developed for the health department. Conclusions The typical approach for analyzing human service contracts based on headquarters is misleading -- in fact, we find that results are reversed when service sites and walkable access are taken into account. This prototype provides an alternative framework for avoiding these misleading results. |
| Databáze: | OpenAIRE |
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