Designing utilization-based spatial healthcare accessibility decision support systems: A case of a regional health plan

In the U.S., myriad healthcare reforms have begun to show some positive effects on enabling “potential access”. One facet of healthcare access, “having access”, which is the availability and accessibility of health services for the surrounding populations, has not been adequately addressed. Research regarding “having access” is presently championed by a family of methods called Floating Catchment Area (FCA). However, existing scholarship is limited in integrating non-spatial factors within the FCA methods. In this research, we propose a novel utilization-based framework as the first attempt to adopt the Behavioral Model of Health Services Use as a theoretical lens to integrate non-spatial factors in spatial healthcare accessibility research. The framework employs a unique approach to derive categorical and factor weights for different population subgroup's healthcare needs using predictive analytics. The proposed framework is evaluated using a case study of a regional health plan. A Spatial Decision Support System (SDSS) instantiates the framework and enables decision makers to explore physician shortage areas. The SDSS validates the practicality of the proposed utilization-based framework and subsequently allows other FCA methods to be implemented in real-world applications.