GRAVITY MODEL APPLICATIONS IN HEALTH PLANNING: ANALYSIS OF AN URBAN HOSPITAL MARKET

In this paper a gravity model is formulated to model a hospital patient flow system. Both spatial and nonspatial measures of separation are used to estimate the model. Travel time was found to provide improved fits over linear distance in modeling patient flow behavior. Transformations of travel tim...

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Bibliographic Details
Published inJournal of regional science Vol. 36; no. 3; pp. 437 - 461
Main Authors Lowe, John M., Sen, Ashish
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.08.1996
Regional Science Research Institute
Blackwell Publishers Inc
Subjects
Analysis
Bgi / Prodig
Choice
Economic models
Economic theory
Geography
Geography of markets and trade services
Health care expenditures
Health economics
Hospitals
Human geography
Medical schools
Patients
Services
Shutdowns
Studies
Urban areas
USA
Chicago
United States of America
Illinois
Accessibility
Time-distance
Gravity model
Service
Management
Hospital
Market
Origin-destination
Flow
Location
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Summary:In this paper a gravity model is formulated to model a hospital patient flow system. Both spatial and nonspatial measures of separation are used to estimate the model. Travel time was found to provide improved fits over linear distance in modeling patient flow behavior. Transformations of travel time (square root and log) were found to improve model performance further. Model diagnostics suggested additional spatial separation measurw, separation measure parameters demonstrated stability over time. The model is used to forecast the effects of health care financing reform and hospital closure on patient flows in an urban hospital market. Universal health coverage was found to dramatically improve access to hospital services for lower income patient populations. Hospitals at risk for closure were forecast to receive increased patient flows. Medical school hospitals are expected to lose patients after implementation of health reform, with important implications for graduate medical education. Hospital closures were shown to have negative effects on access to services in poor neighborhoods, but relatively little effect on access in the system as a whole.
Bibliography:ArticleID:JORS437
ark:/67375/WNG-G3X1041V-M
We are grateful to Tony E. Smith and four anonymous reviewers for their helpful comments in developing this paper. We also thank the Illinois Hospital Association for providing the hospital trip data and the Agency for Health Care Policy and Research for its support through Grant No. HS06949.
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ISSN:0022-4146
1467-9787
DOI:10.1111/j.1467-9787.1996.tb01111.x