ABSTRACT
Broad disparities persist in access to healthcare and health outcomes in the United States, especially among vulnerable populations. An important step towards improving their healthcare access is to ensure "having access", or "accessibility". Drawing together the Behavioral Model of Health Services Use, social determinants of health (SDOH), and spatial healthcare accessibility literature, the research attempts to create an integrative accessibility measure to support the improvement of "having access" for vulnerable populations. A Vulnerable Population Healthcare Accessibility Framework (VPHAF) is proposed to systematically integrate vulnerable population characteristics, health behavior, customer satisfaction, and other SDOH factors to measure healthcare accessibility using advanced analytics. The qualitative and quantitative evaluation of VPHAF demonstrates that it enhances the existing spatial accessibility methods. An intelligent spatial decision support system (SDSS) instantiates the framework to support the decision making in improving healthcare accessibility for vulnerable populations in a regional healthcare plan. The system was evaluated by decision makers from a real-world organization as a useful tool with high usability. The intelligent SDSS enables the collection of SDOH data from multiple sources and uses analytics to measure healthcare accessibility focusing on characteristics of vulnerable populations. Policymakers and health plan providers can use the system to increase awareness of social risks and advocate for better policy decisions in creating equitable healthcare access and reducing health disparity.
