Spatial Difference of Transit-Based Accessibility to Hospitals by Regions Using Spatially Adjusted ANOVA

Int J Environ Res Public Health. 2019 May 30;16(11):1923. doi: 10.3390/ijerph16111923.

Abstract

This paper proposes a spatial difference analysis method for evaluating transit-based accessibility to hospitals using spatially adjusted ANOVA. This method specializes in examining spatial variations of accessibility to hospitals by regions (i.e. administrative districts or subdistricts). The spatial lag model is applied to adjust traditional ANOVA, which reduces spatial dependency and avoids false rejection to null hypothesis. Multiple comparison methods are used for further detection of differences in accessibility between regions. After multiple comparison, accessibility within regions is classified into three levels. The study is conducted on two scales-administrative districts and subdistricts-to discuss spatial variations in macro and micro dimensions respectively in the central part of Wuhan, China. Accessibility is calculated by using a simple model and a gravity model. The final classification results showed that the spatially adjusted method is more reliable than the traditional non spatially adjusted one and the gravity model can better detect more hidden information about the inequal distribution of medical resources. It is also found that the subdistricts, which have significantly lower accessibility to hospitals than others, are mainly distributed in Hongshan and Qingshan district. Our study hopes to shed new lights in spatial difference analysis for accessibility and provide policy recommendations that would promote equality in provisions of public health services.

Keywords: ANOVA; Spatial difference; accessibility; spatial lag model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • China
  • Health Resources
  • Health Services Accessibility / statistics & numerical data*
  • Hospitals*
  • Humans
  • Spatial Analysis