ABSTRACT
An important variable in measuring potential access is the competitive nature of the service being provided. Health services such as physician visits or hospital beds are often viewed as rival goods where one's consumption of a service will diminish another's ability to consume the same service. Congestion at facilities is as important as the overall level of supply at facilities. For rival goods, accessibility and congestion are linked as reciprocal concepts. The relationship between accessibility and congestion is even more important in the current era of the COVID-19 pandemic because critical care services, such as the need for intensive care unit beds, illustrate the need to focus on a balanced level of congestion among hospitals to prevent care failure at the local level. This research investigates the role of service congestion in various existing and proposed models and measures using data from the state of Illinois. Because evenness of service congestion and lower travel times are conflicting goals, evenness of congestion as measured by Gini coefficients is weighed against the cost of travel to determine a compromise solution. Results suggest that the rational agent access model and the congested supply accessibility model provide such compromises when used in conjunction with the transportation problem.
ABSTRACT
An important variable in measuring potential access is the competitive nature of the service being provided. Health services such as physician visits or hospital beds are often viewed as rival goods where one's consumption of a service will diminish another's ability to consume the same service. Congestion at facilities is as important as the overall level of supply at facilities. For rival goods, accessibility and congestion are linked as reciprocal concepts. The relationship between accessibility and congestion is even more important in the current era of the COVID-19 pandemic because critical care services, such as the need for intensive care unit beds, illustrate the need to focus on a balanced level of congestion among hospitals to prevent care failure at the local level. This research investigates the role of service congestion in various existing and proposed models and measures using data from the state of Illinois. Because evenness of service congestion and lower travel times are conflicting goals, evenness of congestion as measured by Gini coefficients is weighed against the cost of travel to determine a compromise solution. Results suggest that the rational agent access model and the congested supply accessibility model provide such compromises when used in conjunction with the transportation problem. © 2022 by American Association of Geographers.
ABSTRACT
Access to hospitals and especially intensive care units is an important issue given the current COVID-19 pandemic. This study examined the interplay between the pattern of spatial separation of racial groups and the access by those groups to hospital services as measured by the number of beds. Differences between racial groups in the Chicago Area were investigated using two models that calculated supply and cost accessibility to hospital care using Huff-style probabilities. An additional two models focused on minimizing the unevenness in congestion for ICU beds at hospitals. Results suggest that with respect to hospital beds, there was not much difference between racial groups in terms of supply accessibility, but there were greater differences in the travel cost for accessing those services. This is due to the association between the centrality dimension of residential segregation and the central location of hospitals in the Chicago Area. Results also suggest that the goal of even congestion levels results in higher travel costs with the region. © The Author(s) 2022.