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Review of related literature about barangay health centers

The ability to generalize the results of this study is limited by the use of 1990 U. Census Bureau data and by changes that can occur due to mobility of the population as well as by the use of only one of 254 counties in the state of Texas.

Still, the researchers concluded that while the study of unmarried teen births and its variables is complex, this sophisticated technology was able to integrate and analyze teen births and census data together to identify where problems exist geographically. GIS analyses provided valuable information to use in solving problems through policy deliberations and health resource allocations. Census Bureau 2000 Census data and analyzed by the SatScan program, version 4.

County centroids were used as a proxy for county locality. The Spatial Scan Statistic was used to identify localized hot spots of excess events.

It has the capability to search for clusters of cases and test for statistical significance across uneven geographical population densities and conditions. Four regions of excess breast cancer mortality were identified. Excess mortality was identified involving multiple racial groups in three counties in southwest Texas and nine counties in central Texas. While geographical variations in breast cancer mortality were evident among racial groups, this study failed to demonstrate hot spot clusters or persistent spatiotemporal trends of excess mortality due to breast cancer.

Human subject protection was achieved by removing all personal identifiers. Several implications were noted from this study.

And lastly, the mapping of the geographical distribution of PCP index values provides additional information beyond simple AIDS density that is valuable for targeting prevention and service delivery to improve access and reduce morbidity and mortality in persons with HIV. Many socioeconomic variables were available in the census data that allowed the researchers to characterize the regional and environmental conditions associated with leptospirosis.

This research used urbanization patterns, income, sanitation, and population distribution. Census tracts unit of analysis proximal to leptospirosis cases were identified using buffers around cases i. ANOVA was used to determine the influence of radius 50—1500 m on the presence of leptospirosis cases categorical variables. The sociospatial indicators associated with leptospirosis cases review of related literature about barangay health centers census tract that were found to be significant at varying distances were flood risk area 50—1000 msolid waste collection 150—600 mpopulation density 150—600 msewerage coverage 200—1000 mwater supply coverage 200—600 mproportion of houses 400—600 mand population per household 500—1500 m.

Healthcare Access, Health Outcomes, and GIS Technology Disparities in health outcomes across populations and geographical regions may reflect differences in access to healthcare services. Many studies have shown the effect of access barriers on healthcare service review of related literature about barangay health centers and the effect of low access on health outcomes.

  • An even more sophisticated measure is the computation of the proportion of the population within a specified travel time of healthcare facilities as demonstrated in this study;
  • The limitations of data collection by questionnaire and the validity and reliability of GIS analysis were not discussed;
  • Proximity was used to measure high and low access, with zip codes containing or contiguous to a clinic classified as high access and all other zip codes as low access;
  • One observed strength of this study is the very large national sample size of the NLMS data set;
  • Human subject protection was achieved by removing all personal identifiers.

Studies that look at access and disparate health outcomes are important to understanding and changing how and where healthcare services are located. In this study the authors sought to 1 identify geographical communities zip codes with high and low access to primary care clinics that serve ethnic and racial minorities, 2 describe sociodemographic characteristics of high- and low-access communities, 3 compare the rates of selected health outcomes for blacks the largest minority between high- and low-access communities, and 4 develop a model to estimate number of lives saved by primary care clinics.

Proximity was used to measure high and low access, with zip codes containing or contiguous to a clinic classified as high access and all other zip codes as low access. ANOVA was used to compare mean values of demographic variables between high- and low-access locations for both maternal and child health and chronic disease mortality outcome measures.

Linear modeling was used to compare rates between high- and low-access areas for the outcome measures. Of the five models used to model chronic disease mortality health outcomes, only one diabetes did not show a significant difference for predicted rates. In terms of number of lives saved, this study estimated that more than 130 deaths would occur among blacks each year if blacks in the area of study had only low access to primary care programs.

In this study, Howard et al. Census Bureau during the period from 1979 to 1985. The existence of this region is not completely understood but may be due to increased prevalence of CVD risk factors, decreased access to healthcare services, or other geographical factors.

As mentioned earlier, low SES has been associated with decreased access to care, and decreased access has been associated with increased review of related literature about barangay health centers. Findings of the study showed that for ages 35 to 54 and 55 to 74 years, stroke mortality was 1. Three major limitations of the research were noted.

First is the lack of data in the data set to allow for closer study of the traditional risk factors and mortality. A second limitation is that the determination of death due to stroke was dependent on death certificate information. Finally, the use of family income and education as proxy variables for SES may not reflect the complexity of SES, and better measures could reflect a greater association between stroke mortality and SES.

One observed strength of this study is the very large national sample size of the NLMS data set. The guidelines allowed 60 minutes for stroke recognition and emergency room evaluation, which left 120 minutes for transport time.

The researchers used ambulance databases to determine the correspondence between time and distance. Travel times of 60, 90, and 120 minutes were found to be equated to distances of 32, 64, and 150 kilometers respectively or 20, 40, and 65 miles. Using GIS software and the Canadian census data 1991 and interim 1996 census counts, the researchers determined the proportions of the Canadian population living within 60, 90, and 120 minutes of hospitals capable of delivering intravenous thrombolysis for acute review of related literature about barangay health centers.

In the Canadian population, 67. One flaw of this study was the use of crude empirical measures of accessibility. The study used buffer zones of Euclidean or straight-line distances that are not the best measure of travel time. Another limitation is the use of ambulance records to calculate the average relationship between distance and travel time.

  • Findings of the study showed that for ages 35 to 54 and 55 to 74 years, stroke mortality was 1;
  • Of the five models used to model chronic disease mortality health outcomes, only one diabetes did not show a significant difference for predicted rates;
  • First is the lack of data in the data set to allow for closer study of the traditional risk factors and mortality;
  • But there remain many unexplained differences in measures of access;
  • The purpose of this article was to determine the link between GIS use and the evaluation of healthcare access and health outcomes.

Even with the identified limitations, the GIS was able to integrate census data and provide measures of healthcare access. The availability of geospatial databases and recent improvements in microcomputer-based GIS technology has made the analysis of travel time more realistic and affordable.

An even more sophisticated measure is the computation of the proportion of the population within a specified travel time of healthcare facilities as demonstrated in this study. Information was obtained using a questionnaire about the patient's home postcode, means of travel to the practice, and perception of accessibility of local AED services.

They also obtained information from medical records of patients attending the local AED. The results showed a distance decay effect: Furthermore, as much as a fourfold variation between the 20 postcodes surveyed was noted.

The investigation of potential socioeconomic factors suggested that those with lower AED usage might be those with lower socioeconomic scores.

Findings also reveal that patients appear to believe they live closer to services than they do. Several important limitations of this research were noted. The authors discuss statistical analysis and controlling for variables but do not give these statistical results.

The limitations of data collection by questionnaire and the validity and reliability of GIS analysis were not discussed. Summary of Findings Research Question 1: Health research using GIS technology has demonstrated environmental variables of Lyme disease, correlated sociodemographic variables and teen pregnancy, analyzed geographical disparities in breast cancer mortality by racial groups, demonstrated heart disease and stroke mortality, mapped PCP and AIDS prevalence, analyzed access to emergency departments, and identified factors of a leptospirosis disease outbreak.

GIS Effectiveness Studies presented here have related health outcomes to the level of access to healthcare.

  • Studies that look at access and disparate health outcomes are important to understanding and changing how and where healthcare services are located;
  • A second limitation is that the determination of death due to stroke was dependent on death certificate information;
  • The studies reviewed have demonstrated environmental variables of Lyme disease, correlated sociodemographic variables and teen pregnancy, analyzed geographical disparities in breast cancer mortality by racial groups, mapped PCP and AIDS prevalence, and identified factors of a leptospirosis disease outbreak;
  • In this study, Howard et al;
  • Excess mortality was identified involving multiple racial groups in three counties in southwest Texas and nine counties in central Texas.

GIS technology was useful in the evaluation of environmental conditions and Lyme disease. Studies have further related heart disease and stroke mortality to geographical location of healthcare services. Geographical mapping provided for visualization of relationships between teen births and other social factors, as well as showing geographical variations in breast cancer among racial groups.

GIS technology was able to demonstrate both unequal access and unequal health outcome for many priority populations blacks, women, and geographical region. GISs were effective analytical tools for the evaluation and study of healthcare access and health outcomes in the cited studies.

Whether it is problems with environmental risk or exposure, poor health screening, or a lack of access to basic resources, geography can be vital in the assessment of health issues.

The implications for the use of GIS technology in healthcare are vast. In the studies cited, disparities in access to healthcare services are associated with barriers to access such as age, sex, race, ethnicity, income, insurance status, and place of residence. Studies of medical geography and epidemiology well document significant variations in health over even small geographical areas. Geographical proximity to healthcare services review of related literature about barangay health centers shown to be a strong predictor of disparities.

But there remain many unexplained differences in measures of access. More studies are needed to evaluate the impact of geographical access and important outcome measures of health. The field of health geography could benefit from studies that provide greater understanding of patterns of geography, healthcare access, and health outcomes.

GIS analyses can serve to guide policy deliberations and health resource allocations. They can be instrumental for targeting of interventions to improve geographical healthcare disparities. The literature cited collectively indicates the interrelated aspects of geography, accessibility, and health. What is not yet understood is the specific relationship of specific populations in their unique geographical contexts.

Introduction

More research is needed to explore specific social and geographical variables of specific at-risk populations. Further research is also needed in the use of GIS technology to both visually identify and empirically measure spatial relationships of geographical, environmental, and social influences on disease and other health issues. GISs can provide the technology and methodology for the study of the web of causation of health disparities.

Information regarding access to healthcare services for specific populations could better describe the healthcare needs of those at risk, such as rural, elderly, low-income, and black populations, as well as specific geographical areas. Research of this nature could serve to assist healthcare planners and those who make decisions about the location of healthcare services. The field of health geography is evolving through the use of evidence-based studies.

Sufficient research is available to support the use of GIS as an effective technology for the study of healthcare access and health outcomes. Knowledge generated from empirical research can form a basis for the understanding of health access and health outcomes and for the development of intervention programs to resolve health disparities. Conclusion Health is an outcome of multiple determinants. Review of related literature about barangay health centers biology and behaviors, physical and social environments, policies and interventions, and access to quality healthcare are predisposing factors that can contribute to the health of people and communities.

The predisposing factors of health status are often interdependent and interrelated, creating a complex web of causation. They can be effective in the integration and analysis of physical, social, and cultural environments.

Review of related literature about barangay health centers

The purpose of this article was to determine the link between GIS use and the evaluation of healthcare access and health outcomes. The studies reviewed have demonstrated environmental variables of Lyme disease, correlated sociodemographic variables and teen pregnancy, analyzed geographical disparities in breast cancer mortality by racial groups, mapped PCP and AIDS prevalence, and identified factors of a leptospirosis disease outbreak. GIS technology offers many advantages in data integration, interactive querying of databases and design, and presentation of findings in the form of maps.

Both the visual impact and the data analysis provided by GISs are advantages that support their use. The ability to overlay data layers allows for interpretation beyond that seen with traditional research and statistical methods.

The studies reviewed used GISs to both empirically measure and visually identify and explore spatial relationships of health and heath variables. GIS use was effective in the investigation of various aspects of healthcare access and health outcomes and therefore can be an asset in the understanding and resolution of health disparities.

National Academy of Sciences; 2002. National Healthcare Disparities Report.