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Explaining spatial accessibility to high-quality nursing home care in the US using machine learning.

Brian P Reddy1, Stephen O'Neill2, Ciaran O'Neill3

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Spatial accessibility to quality nursing home care varies significantly across U.S. counties, influenced by population density and minority populations. This research highlights disparities and suggests policy improvements.

Keywords:
AccessibilityData scienceEquityHealth economicsMachine learningNursing homes

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Area of Science:

  • Health Services Research
  • Geospatial Analysis
  • Machine Learning Applications in Healthcare

Background:

  • Access to quality nursing home care is crucial for elderly populations.
  • Significant geographic disparities in healthcare access are suspected but not systematically mapped.
  • Understanding these disparities is key to improving geriatric care outcomes.

Purpose of the Study:

  • To measure and map spatial accessibility to good quality nursing home care across all contiguous U.S. counties.
  • To examine associations between nursing home accessibility and county-level socio-demographic factors.
  • To identify policy implications for addressing identified access shortcomings.

Main Methods:

  • Utilized publicly available datasets for comprehensive analysis.
  • Employed an 'imputed post-lasso' machine learning technique for systematic examination.
  • Mapped system-wide spatial accessibility at the county level.

Main Results:

  • Identified clear spatial patterning in nursing home care accessibility.
  • Accessibility variations were notably associated with population density, state, and minority populations.
  • Machine learning model demonstrated strong 'out-of-sample' predictive performance.

Conclusions:

  • Significant geographic disparities in nursing home care access exist across the U.S.
  • Socio-demographic factors, including race and population density, are linked to these access differences.
  • Policy interventions are needed to mitigate identified access barriers and improve equitable care delivery.