MEASURING GEOGRAPHIC ACCESSIBILITY WITH GIS-TOOL: A RISK EVALUATION AND PLANNING TO AGAINST PANDEMIC INFLUENZA IN TAIWAN

As part of a comprehensive preparation plan to defend against the fast spread of acute influenza in Taiwan, the present study was conducted to compare the medical care accessibility of residents in 25 communities throughout Taiwan to ensure uniform adequacy of medical care facilities to provide timely treatment for acute influenza outbreaks. GIS techniques were used to estimate the percent of residents with access to a medical care facility within three miles from a patient’s residence, taking into account the availability of roadways. This level of medical care accessibility (MCA) was found to have a rather wide distribution. In highly developed urban communities such as those in Taipei City, over 90% of residents enjoy the proper MCA, whereas in less developed rural communities such as those in Chiayi County, less than 20% of residents have the same MCA. We also illustrate the significant application in health risk management, by assessing the community medical care accessibility in a rural county, Miaoli County, using WHO AccessMod. The non-accessibility area can be “scaled-up” and simulated to show how many and what kinds of health facilities were needed in determining populations at risk during influenza epidemic.

Our results provide national health authorities with rationalized strategic sites for investment in building additional medical care facilities or relocation of existing facilities to narrow the gaps in MCA for better defense against acute influenza. The methodologies we developed in this study demonstrate the power of combining GIS techniques, roadmap and demographic analyses, and mining of census data in public health research.