inequalities in transport accessibility to healthcare facilities - - PowerPoint PPT Presentation

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inequalities in transport accessibility to healthcare facilities - - PowerPoint PPT Presentation

Dec 18, 2022 268 likes •402 views

Institute for Transport Studies FACULTY OF ENVIRONMENT Using health data to explore inequalities in transport accessibility to healthcare facilities Charlotte Kelly Institute for Transport Studies & Academic Unit Health Economics

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SLIDE 1

Institute for Transport Studies

FACULTY OF ENVIRONMENT

Using health data to explore inequalities in transport accessibility to healthcare facilities

Charlotte Kelly Institute for Transport Studies & Academic Unit Health Economics c.e.kelly@leeds.ac.uk

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Health & Transport

Barton and Grant (2006) A health map for the local human habitat http://dx.doi.org/10.1177/1466424006070466

Complex interaction of many contributing factors between transport and health

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Accessing Healthcare

Majority of patients have to get to the appointment!

  • Some examples of remote testing/ tele-medicine

Assumption that people can get there, BUT…

  • 31% of people without a car have difficulty travelling to their local

hospital & 17% with a car (SEU, 2003)

Growing body of research showing evidence of a distance decay effect (Kelly et al, 2016)

  • e.g. later stage cancer diagnosis of patients living further from GP
  • Some solutions – patients having to travel long distances for

specialised care - associations with poorer health were reduced where follow up was local.

A need for more joined up transport / healthcare planning

  • e.g. Context of centralisation/ relocation of healthcare services
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SLIDE 4

Health Data available - examples

  • Hospital Episodes Statistics (HES) (NHS Digital)
  • 15.5 million NHS inpatient admissions & >100 million outpatient appointments

(2013-2014)

  • Variables include – Diagnosis / treatment, age, gender, ethnicity, locations

etc…

  • Linked to other databases STATS19, PROMS, Cancer registries etc…
  • English Longitudinal Study on Ageing (ELSA) (UK data Service)
  • Cohort of 12,000 individuals > 50 years old
  • Variables include - use of public transport, diagnosis, quality of life, walk

speed, BMI, income, cars owned and type etc…

  • Examples of use Arthritis UK - prevalence by area.
  • ResearchOne - http://www.researchone.org/
  • + Many Others
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SLIDE 5

Example: Potential Relocation

  • f Healthcare Services

Using:

  • HES data - Patients with an LS postcode having a hip/knee operation

between 2009/10 – 2011/12

  • Data on individuals (diagnosis, age, gender, deprivation level of

residence, postcode etc..)

  • Linked - patient reported outcome measures data (health data).
  • GIS (ESRI ArcGIS 10.4 and Visography TRACC)
  • Calculate distance/ travel times - home postcode to hospital attended
  • Investigate potential location of hospitals/ issues with access
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SLIDE 6

Leeds Residents: Hip and Knee Replacements (2009/10 – 2011/12)

RXF10 RXF05 RXF05 RXF03 RXF03 RWY02 RTRAT RR819 RR801 RP5DR RHQNG RCF22 RCD01 RCB55 RAE00 NVC28 NT447 NT350 NT349 NT332 NT245 NT225

.

3, 213 patients with LS postcode Average distance 10km Minimum 0.35km Maximum 86km Travel further if:

  • Male
  • Live in less deprived locations
  • No Comorbidities
  • Higher self assessed quality of life
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SLIDE 7

Leeds Residents: Hip and Knee Replacements (2009/10 – 2011-12)

RXF10 RXF05 RXF05 RXF03 RXF03 RWY02 RR819 RR801 RCF22 RCD01 RCB55 RAE00 NVC28 NT447 NT350 NT349 NT332 NT225

4 8 2 Miles

.

Number of operations (2009/10 - 2010/11)

Hospitals

F4

1 - 10 11 - 28 29 - 120 121 - 860 861 - 1329

Transverse Mercator & British National Grid Source: Edina Boundaries & NHS Digital Created by C Kelly

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SLIDE 8

Optimal location ?

"

RXF10 RXF05 RXF05 RXF03 RXF03 RWY02 RR819 RR801 RCF22 RCD01 RAE00 NVC28 NT447 NT350 NT349 NT332 NT225

3.5 7 1.75 Miles

.

Number of operations (2009/10 - 2010/11)

"

Mean Centre

Hospitals

F4

1 - 10 11 - 28 29 - 120 121 - 860 861 - 1329

Transverse Mercator & British National Grid Source: Edina Boundaries & NHS Digital Created by C Kelly

3, 213 patients with LS postcode Mean Centre

  • Average distance

8.8km

  • Minimum 0.25km
  • Maximum 25km
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SLIDE 9

Optimal location? (weighted by residential deprivation)

"

" )

RXF10 RXF05 RXF05 RXF03 RXF03 RWY02 RR819 RR801 RAE00 NT350 NT349 NT332 NT225

3 6 1.5 Miles

.

Number of operations (2009/10 - 2010/11)

" )

Mean Weighted by Deprivation

"

Mean Centre

Hospitals

F4

1 - 10 11 - 28 29 - 120 121 - 860 861 - 1329

Transverse Mercator & British National Grid Source: Edina Boundaries & NHS Digital Created by C Kelly

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Harrogate

  • Average 20km
  • Most deprived 21.8km

(6.4km original)

  • Least deprived 18km

(12.4km – original) Chapel Allerton

  • Average 9km

Impact of everyone going to Harrogate

RXF10 RXF05 RXF05 RXF0 RXF03 WY02 RR819 RR801 RCD01 RAE00 NT447 NT350 NT349 NT332 NT225

.

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Impact of everyone going to Harrogate: By Bus

~1/3 could not get to Harrogate hospital by bus for a 9am appointment. Average travel time = 78mins Min 12 mins Max 119 mins Knock on effect for patient transport services?

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Conclusions

  • How, where and when patients access healthcare has a

major impact on the NHS budget & patients health.

  • Ageing population and increasing demand – increasing

problem

  • Large scope to use health and transport data in joint

planning.