基于传统与感知旅行时间测量的阿片类药物治疗计划的可访问性
Junghwan Kim1, Jinhyung Lee2, Thomas A Thornhill3,4
1Department of Geography, College of Natural Resources and Environment, Virginia Tech, Blacksburg.
JAMA network open
|February 20, 2024
概括
一个新的"感觉"可访问性指标显示,对于获得治疗的阿片类药物使用障碍 (OUD) 患者来说,交通负担很大. 该指标比传统指标更好地反映了现实世界的旅行挑战,突出了获得阿片类药物治疗计划 (OTP) 的不平等.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 运输科学 运输科学
背景情况:
- 交通障碍对健康结果产生重大影响,特别是对于阿片类药物使用障碍 (OUD) 患者,这种慢性疾病通常与社会经济劣势有关.
- 传统的旅行时间分析可能低估了真正的旅行负担,并高估了OUD寻求阿片类药物治疗计划 (OTP) 服务的OUD患者的治疗可用性.
- 旅行的体验性组成部分,如步行和等待时间,对于准确评估弱势群体的可访问性至关重要.
研究的目的:
- 开发和验证"感觉"可访问性指标,用于公共交通用户访问OTPs.
- 为了解决OUD患者的现实旅行负担,包括车外时间.
- 识别和量化运输中的不平等,使OTP可访问.
主要方法:
- 一项横截面研究,整合了高分辨率的公共交通时间表和OTP营业时间.
- 开发一种"感觉式"的可访问性指标,考虑不同的车外旅行组件.
- 分析了康涅狄格州过量死亡 (n=1018) 的地理编码住所地址,作为OUD治疗需求的代理.
- 使用吉尼指数和空间回归模型来评估可访问性不平等.
- "感觉"可访问性与传统可访问性措施的比较.
主要成果:
- 很大一部分个人 (26%) 在180分钟内无法访问OTP.
- 对于那些访问OTP的人来说,车外的旅行部件占总旅行时间的70%左右.
- "感觉"可访问性指标显示,与传统指标相比,旅行负担和不平等性更大.
- 平均"感觉"可访问性 (1.0 OTP在120分钟内) 远低于传统可访问性 (5.0 OTP在120分钟内).
- 根据出发时间观察到旅行时间和可访问性的相当大的时间差异.
结论:
- "感觉"可访问性指标提供了对访问OTP的运输负担的更现实的评估.
- 传统的可访问性指标可能会误导有关治疗准入的政策制定.
- 调查结果表明,扩大OTP站点位置和延长营业时间可以减轻OUD患者的旅行负担.
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