Spatial Accessibility
2023-7-16
Refining 2SVCA method for measuring telehealth accessibility of primary care physicians in Baton Rouge, Louisiana
This study examined disparities in telehealth versus physical accessibility to primary care across urban-rural and demographic dimensions in Baton Rouge, Louisiana using refined 2SVCA and 2SFCA.
Abstract:
Equity in health care delivery is a longstanding concern of public health policy. Telehealth is considered an important way to level the playing field by broadening health services access and improving quality of care and health outcomes. This study refines the recently developed “2-Step Virtual Catchment Area (2SVCA) method” to assess the telehealth accessibility of primary care in the Baton Rouge Metropolitan Statistical Area, Louisiana. The result is compared to that of spatial accessibility via physical visits to care providers based on the popular 2-Step Floating Catchment Area (2SFCA) method. The study shows that both spatial and telehealth accessibilities decline from urban to low-density and then rural areas. Moreover, disproportionally higher percentages of African Americans are in areas with higher spatial accessibility scores; but such an advantage is not realized in telehealth accessibility. In the study area, absence of broadband availability is mainly a rural problem and leads to a lower average telehealth accessibility than physical accessibility in rural areas. On the other side, lack of broadband affordability is a challenge across the rural-urban continuum and is disproportionally associated with high concentrations of disadvantaged population groups such as households under the poverty level and Blacks.
Summary:
- Study examines disparities in telehealth vs physical accessibility to primary care in Baton Rouge, Louisiana
- Refines 2-Step Virtual Catchment Area (2SVCA) method to measure telehealth accessibility
- Physical and telehealth accessibility decline from urban to rural areas
- Lack of broadband availability mainly a rural problem, leading to lower telehealth vs physical accessibility
- Lack of broadband affordability an issue across urban-rural continuum, disproportionately affecting disadvantaged groups
- Areas with higher black concentration have better physical but poorer telehealth accessibility
Study questions and answers:
| Study Questions | Answers |
|---|---|
| What methods were used to measure physical and telehealth accessibility? | 2-Step Floating Catchment Area (2SFCA) for physical, refined 2-Step Virtual Catchment Area (2SVCA) for telehealth |
| How did physical and telehealth accessibility vary by urban-rural status? | Both declined from urban to rural areas |
| What was the main factor limiting telehealth accessibility in rural areas? | Lack of broadband availability |
| What was the main factor limiting telehealth across urban-rural continuum? | Lack of broadband affordability |
| How did areas with higher black concentration fare in physical vs telehealth accessibility? | Better physical but poorer telehealth accessibility |