New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers: A cross-sectional study

Shyang Woei Lin, Chia Feng Yen, Tzu Ying Chiu, Wen Chou Chi, Tsan Hon Liou

研究成果: 雜誌貢獻文章

6 引文 (Scopus)

摘要

Background: Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4 % of people aged 15 or above live with a disability, and 15.3 % of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". Methods: This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. Results: There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3 % of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9 % in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Conclusions: Our new "profit willing distance" and the "tolerance limited distance" are considered to be clearer and more equitable than other evaluation indices. They have practical application in considering resource distribution issues around the world, and in particular the rural-urban disparities for public resource.

原文英語
文章編號28
期刊International Journal of Health Geographics
14
發行號1
DOIs
出版狀態已發佈 - 十月 8 2015

指紋

Geographic Mapping
Home Nursing
Nursing
Home Care Services
Nursing Care
Cross-Sectional Studies
Taiwan
Independent Living
Nursing Services
Geographic Information Systems
Profitability
Resource Allocation
Long-Term Care
Appointments and Schedules
Nursing homes
Urban areas
Cross-sectional studies
Resources
Rural areas
Geographic information systems

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Computer Science(all)
  • Business, Management and Accounting(all)

引用此文

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title = "New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers: A cross-sectional study",
abstract = "Background: Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4 {\%} of people aged 15 or above live with a disability, and 15.3 {\%} of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the {"}profit willing distance{"} and the {"}tolerance limited distance{"}. Methods: This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. Results: There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3 {\%} of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9 {\%} in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Conclusions: Our new {"}profit willing distance{"} and the {"}tolerance limited distance{"} are considered to be clearer and more equitable than other evaluation indices. They have practical application in considering resource distribution issues around the world, and in particular the rural-urban disparities for public resource.",
keywords = "Disparities, Geographic information system, Home nursing care, Long-term care, WHODAS 2.0",
author = "Lin, {Shyang Woei} and Yen, {Chia Feng} and Chiu, {Tzu Ying} and Chi, {Wen Chou} and Liou, {Tsan Hon}",
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TY - JOUR

T1 - New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers

T2 - A cross-sectional study

AU - Lin, Shyang Woei

AU - Yen, Chia Feng

AU - Chiu, Tzu Ying

AU - Chi, Wen Chou

AU - Liou, Tsan Hon

PY - 2015/10/8

Y1 - 2015/10/8

N2 - Background: Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4 % of people aged 15 or above live with a disability, and 15.3 % of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". Methods: This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. Results: There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3 % of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9 % in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Conclusions: Our new "profit willing distance" and the "tolerance limited distance" are considered to be clearer and more equitable than other evaluation indices. They have practical application in considering resource distribution issues around the world, and in particular the rural-urban disparities for public resource.

AB - Background: Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4 % of people aged 15 or above live with a disability, and 15.3 % of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". Methods: This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. Results: There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3 % of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9 % in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Conclusions: Our new "profit willing distance" and the "tolerance limited distance" are considered to be clearer and more equitable than other evaluation indices. They have practical application in considering resource distribution issues around the world, and in particular the rural-urban disparities for public resource.

KW - Disparities

KW - Geographic information system

KW - Home nursing care

KW - Long-term care

KW - WHODAS 2.0

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