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題名 比較不同人口點位對潛在醫療可及性的影響
Comparing potential accessibility to healthcare facilities under different representations of population
作者 陳逸
Chen, I
貢獻者 林士淵<br>范噶色
Lin, Shih-Yuan<br>Stephan van Gasselt
陳逸
Chen, I
關鍵詞 地理可及性
聚合誤差
可調整區域單元問題
Accessibility
Aggregation error
Modifiable areal unit problem
日期 2023
上傳時間 1-Sep-2023 15:14:49 (UTC+8)
摘要 潛在空間可及性是評估資源分配和判別資源缺乏區域常用的概念之一，根據 過往文獻與研究，目前至少有八種方法和指標可以用來量化與計算可及性，然而， 由於資料可得性和隱私權問題，大多數過往的研究與政府報告所計算的可及性是 基於區域的可及性，而不是基於個人的可及性，基於區域所計算的可及性會有以 下兩個問題:可調整區域單元問題以及聚合錯誤，前者表示選擇不同尺度與劃分 的區域單元會產生不同的分析結果，後者表示用單一點位來表示一個區域單元內 人口的空間分布，若計算基於區域的可及性時，沒有考慮到上述問題，某些區域 的可及性將會被低估或高估，造成錯誤的判斷與解讀。
隨著更精細的空間單元與其他資料的開放與提供，目前已經可以精確定位出 人口真正居住的位置，並且計算基於個人的可及性，從而減少甚至消除可調整區 域單元問題和聚合誤差的影響，因此，本研究嘗試使用國土利用現況調查地圖， 篩選出居住區來代表人口真實分佈的位置，計算基於個體的可及性，並比較基於 區域以及基於個人的可及性，評估聚合誤差的大小和數量。
研究結果顯示，即使使用最精細的空間單元，也就是最小統計區，仍然有些 地方出現顯著且極大的聚合誤差，且該誤差的空間分佈不一定聚集於某些特定區 域，因此建議未來研究若要以潛在空間可及性的概念來評估資源配置時，在資料 可得性允許的情況下，計算基於個人的可及性，以消除可調整區域單元問題和聚 合誤差，獲得最精確的可及性。
Spatial potential accessibility measurement is one of the commonly used concepts to assess the resource allocation and identify the areas with insufficient resource. There are at least eight quantitative approaches and indicators to calculate accessibility. However, due to data availability and privacy issues, most previous studies and government reports calculated zone-based accessibility instead of individual-based accessibility. The will cause two problems: modifiable areal unit and aggregation error. The former means the arbitrary selection and delineation of areal unit will produce different analysis results. The latter means using a single point to represent spatially distributed population within an areal unit. If fail to take these two problems into consideration, one may misinterpret and misestimate the accessibility values.
With the advent of finer areal unit and ancillary data become available, it is possible to pinpoint the areas that population truly reside and calculate individual-based accessibility values, then reduce and eliminate the impact of modifiable areal unit problem and aggregation error. Thus, this dissertation tries to use land use survey map to extract the residential area to represent the places that the population truly distributed and calculate individual-based accessibility values. Compare such values with zone- based accessibility values to evaluate the magnitude and quantity of aggregation error.
The result shows that even use the finest areal unit, there are still some places suffer significant and extremely large aggregation error and the spatial distribution of aggregation error is not necessarily located in some specific areas. Therefore, if possible, it is recommended to calculated individual-based accessibility values to eliminate the modifiable areal unit problem and aggregation error.
參考文獻 Apparicio, P., Abdelmajid, M., Riva, M., & Shearmur, R. (2008). Comparing alternative approaches to measuring the geographical accessibility of urban health services: Distance types and aggregation-error issues. International Journal of Health Geographics, 7(1), 7. doi:10.1186/1476-072X-7-7
Apparicio, P., Cloutier, M.-S., & Shearmur, R. (2007). The case of Montréal`s missing food deserts: Evaluation of accessibility to food supermarkets. International Journal of Health Geographics, 6(1), 4. doi:10.1186/1476-072X-6-4
Apparicio, P., Gelb, J., Dubé, A.-S., Kingham, S., Gauvin, L., & Robitaille, É. (2017). The approaches to measuring the potential spatial access to urban health services revisited: distance types and aggregation-error issues. International Journal of Health Geographics, 16(1), 32. doi:10.1186/s12942-017-0105-9
Brabyn, L., & Barnett, R. (2004). Population need and geographical access to general practitioners in rural New Zealand. N Z Med J, 117(1199), U996.
Buzzelli, M. (2020). Modifiable areal unit problem. International encyclopedia of human geography, 169.
Cartagena-Colón, M., Mattei, H., & Wang, C. (2022). Dasymetric Mapping of Population Using Land Cover Data in JBNERR, Puerto Rico during 1990–2010. Land, 11(12), 2301. Retrieved from https://www.mdpi.com/2073-445X/11/12/2301
Comber, A., & Zeng, W. (2019). Spatial interpolation using areal features: A review of methods and opportunities using new forms of data with coded illustrations. Geography Compass, 13(10), e12465. doi:https://doi.org/10.1111/gec3.12465
Crooks, V. A., & Schuurman, N. (2012). Interpreting the results of a modified gravity model: examining access to primary health care physicians in five Canadian provinces and territories. BMC Health Serv Res, 12, 230. doi:10.1186/1472-6963-12-230
Dewulf, B., Neutens, T., De Weerdt, Y., & Van de Weghe, N. (2013). Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas. BMC Family Practice, 14(1), 122. doi:10.1186/1471-2296-14-122
Fortney, J., Rost, K., & Warren, J. (2000). Comparing Alternative Methods of Measuring Geographic Access to Health Services. Health Services and Outcomes Research Methodology, 1(2), 173-184. doi:10.1023/A:1012545106828
Guagliardo, M. F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics, 3(1), 3. doi:10.1186/1476-072X-3-3
Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., & Hudson, M. (2002). What does `access to health care` mean? Journal of Health Services Research & Policy, 7(3), 186-188. doi:10.1258/135581902760082517
Hewko, J., Smoyer-Tomic, K. E., & Hodgson, M. J. (2002). Measuring Neighbourhood Spatial Accessibility to Urban Amenities: Does Aggregation Error Matter? Environment and Planning A: Economy and Space, 34(7), 1185-1206. doi:10.1068/a34171
Higgs, G. (2004). A Literature Review of the Use of GIS-Based Measures of Access to Health Care Services. Health Services and Outcomes Research Methodology, 5(2), 119-139. doi:10.1007/s10742-005-4304-7
Higgs, G., Fry, R., & Langford, M. (2012). Investigating the Implications of Using Alternative GIS-Based Techniques to Measure Accessibility to Green Space. Environment and Planning B: Planning and Design, 39(2), 326-343. doi:10.1068/b37130
Hsieh, C.-C., Liao, H.-C., Yang, M.-C., & Tung, Y.-C. (2019). 全民健康保險醫療資源潛在空間可近性分析－以台灣北部四縣市為例. [Potential spatial accessibility of health care resources: an example of four counties and cities in northern Taiwan]. Taiwan Gong Gong Wei Sheng Za Zhi, 38(3), 316-327. doi:https://doi.org/10.6288/TJPH.201906_38(3).108016
Jones, S. G., Ashby, A. J., Momin, S. R., & Naidoo, A. (2010). Spatial implications associated with using Euclidean distance measurements and geographic centroid imputation in health care research. Health Serv Res, 45(1), 316-327. doi:10.1111/j.1475-6773.2009.01044.x
Kelobonye, K., Zhou, H., McCarney, G., & Xia, J. (2020). Measuring the accessibility and spatial equity of urban services under competition using the cumulative opportunities measure. Journal of Transport Geography, 85, 102706. doi:https://doi.org/10.1016/j.jtrangeo.2020.102706
Khan, A. A. (1992). An integrated approach to measuring potential spatial access to health care services. Socio-Economic Planning Sciences, 26(4), 275-287. doi:https://doi.org/10.1016/0038-0121(92)90004-O
Langford, M., & Higgs, G. (2006). Measuring Potential Access to Primary Healthcare Services: The Influence of Alternative Spatial Representations of Population. The Professional Geographer, 58(3), 294-306. doi:10.1111/j.1467-9272.2006.00569.x
Luo, W. (2004). Using a GIS-based floating catchment method to assess areas with shortage of physicians. Health & Place, 10(1), 1-11. doi:https://doi.org/10.1016/S1353-8292(02)00067-9
Luo, W., & Qi, Y. (2009). An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health & Place, 15(4), 1100-1107. doi:https://doi.org/10.1016/j.healthplace.2009.06.002
Luo, W., & Wang, F. (2003). Measures of Spatial Accessibility to Healthcare in a GIS Environment: Synthesis and a Case Study in Chicago Region. Environ Plann B Plann Des, 30(6), 865-884. doi:10.1068/b29120
Masoodi, M., & Rahimzadeh, M. (2015). Measuring Access to Urban Health Services Using Geographical Information System (GIS): A Case Study of Health Service Management in Bandar Abbas, Iran. International Journal of Health Policy and Management, 4(7), 439-445. doi:10.15171/ijhpm.2015.23
Mennis, J. (2003). Generating Surface Models of Population Using Dasymetric Mapping. The Professional Geographer, 55(1), 31-42. doi:10.1111/0033-0124.10042
Neutens, T. (2015). Accessibility, equity and health care: review and research directions for transport geographers. Journal of Transport Geography, 43, 14-27. doi:https://doi.org/10.1016/j.jtrangeo.2014.12.006
Neutens, T., Schwanen, T., Witlox, F., & De Maeyer, P. (2010). Equity of Urban Service Delivery: A Comparison of Different Accessibility Measures. Environment and Planning A: Economy and Space, 42(7), 1613-1635. doi:10.1068/a4230
Penchansky, R., & Thomas, J. W. (1981). The Concept of Access: Definition and Relationship to Consumer Satisfaction. Medical Care, 19(2), 127-140. Retrieved from https://journals.lww.com/lww-medicalcare/Fulltext/1981/02000/The_Concept_of_Access__Definition_and_Relationship.1.aspx
Pereira, R. H. M., Braga, C. K. V., Servo, L. M., Serra, B., Amaral, P., Gouveia, N., & Paez, A. (2021). Geographic access to COVID-19 healthcare in Brazil using a balanced float catchment area approach. Social Science & Medicine, 273, 113773. doi:https://doi.org/10.1016/j.socscimed.2021.113773
Schuurman, N., Berube, M., & Crooks, V. (2010). Measuring Potential Spatial Access to Primary Health Care Physicians Using a Modified Gravity Model. Canadian Geographer / Le Géographe canadien, 54, 29-45. doi:10.1111/j.1541-0064.2009.00301.x
Swanwick, R. H., Read, Q. D., Guinn, S. M., Williamson, M. A., Hondula, K. L., & Elmore, A. J. (2022). Dasymetric population mapping based on US census data and 30-m gridded estimates of impervious surface. Scientific Data, 9(1), 523. doi:10.1038/s41597-022-01603-z
Wang, F. (2012). Measurement, Optimization, and Impact of Health Care Accessibility: A Methodological Review. Ann Assoc Am Geogr, 102(5), 1104-1112. doi:10.1080/00045608.2012.657146
Yang, D.-H., Goerge, R., & Mullner, R. (2006). Comparing GIS-Based Methods of Measuring Spatial Accessibility to Health Services. Journal of Medical Systems, 30(1), 23-32. doi:10.1007/s10916-006-7400-5
Zola K. Moon, F. L. F. (2001). Population Density Surface: A New Approach to an Old Problem. Society & Natural Resources, 14(1), 39-51. doi:10.1080/08941920120013
宋立壵, 王. (2018). 三代同鄰-因應社會高齡化的宜居社區之探討. 內政部建築研究所
章殷超, 溫在弘, & 賴美淑. (2011). 比較不同地理可近性分析方法於評估台灣各鄉鎮每萬人口西醫師數之差異. [Comparisons of Different Methods of Geographical Accessibility in Evaluating Township-level Physician-to-Population Ratios in Taiwan]. 台灣公共衛生雜誌, 30(6), 558-572. doi:10.6288/tjph2011-30-06-06
廖興中. (2014). 臺灣基層醫療缺乏區域界定之初探：整合空間與非空間因素的分析. [Exploring the Definition of Primary Healthcare Shortage Areas in Taiwan: Integrating Spatial and Nonspatial Factors]. 行政暨政策學報(58), 121-152.
蔡明璋, 曾明性, & 吳慧卿. (2018). 臺灣樂齡學習需求人口與樂齡學習中心資源配置差異分析：應用空間群聚與地理可近性方法評估. [A Study on Resource Allocation Comparing the Elderly Population in Need of Learning Centers and Elderly Learning Centers in Taiwan: Evaluating by Spatial Clustering and Geographic Accessibility]. 人口學刊(56), 35-80. doi:10.6191/jps.201806_56.0002
描述 碩士
國立政治大學
地政學系
110257006
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0110257006
資料類型 thesis
dc.contributor.advisor 林士淵<br>范噶色zh_TW
dc.contributor.advisor Lin, Shih-Yuan<br>Stephan van Gasselten_US
dc.contributor.author (Authors) 陳逸zh_TW
dc.contributor.author (Authors) Chen, Ien_US
dc.creator (作者) 陳逸zh_TW
dc.creator (作者) Chen, Ien_US
dc.date (日期) 2023en_US
dc.date.accessioned 1-Sep-2023 15:14:49 (UTC+8)-
dc.date.available 1-Sep-2023 15:14:49 (UTC+8)-
dc.date.issued (上傳時間) 1-Sep-2023 15:14:49 (UTC+8)-
dc.identifier (Other Identifiers) G0110257006en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/146990-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 地政學系zh_TW
dc.description (描述) 110257006zh_TW
dc.description.abstract (摘要) 潛在空間可及性是評估資源分配和判別資源缺乏區域常用的概念之一，根據 過往文獻與研究，目前至少有八種方法和指標可以用來量化與計算可及性，然而， 由於資料可得性和隱私權問題，大多數過往的研究與政府報告所計算的可及性是 基於區域的可及性，而不是基於個人的可及性，基於區域所計算的可及性會有以 下兩個問題:可調整區域單元問題以及聚合錯誤，前者表示選擇不同尺度與劃分 的區域單元會產生不同的分析結果，後者表示用單一點位來表示一個區域單元內 人口的空間分布，若計算基於區域的可及性時，沒有考慮到上述問題，某些區域 的可及性將會被低估或高估，造成錯誤的判斷與解讀。
隨著更精細的空間單元與其他資料的開放與提供，目前已經可以精確定位出 人口真正居住的位置，並且計算基於個人的可及性，從而減少甚至消除可調整區 域單元問題和聚合誤差的影響，因此，本研究嘗試使用國土利用現況調查地圖， 篩選出居住區來代表人口真實分佈的位置，計算基於個體的可及性，並比較基於 區域以及基於個人的可及性，評估聚合誤差的大小和數量。
研究結果顯示，即使使用最精細的空間單元，也就是最小統計區，仍然有些 地方出現顯著且極大的聚合誤差，且該誤差的空間分佈不一定聚集於某些特定區 域，因此建議未來研究若要以潛在空間可及性的概念來評估資源配置時，在資料 可得性允許的情況下，計算基於個人的可及性，以消除可調整區域單元問題和聚 合誤差，獲得最精確的可及性。		zh_TW
dc.description.abstract (摘要) Spatial potential accessibility measurement is one of the commonly used concepts to assess the resource allocation and identify the areas with insufficient resource. There are at least eight quantitative approaches and indicators to calculate accessibility. However, due to data availability and privacy issues, most previous studies and government reports calculated zone-based accessibility instead of individual-based accessibility. The will cause two problems: modifiable areal unit and aggregation error. The former means the arbitrary selection and delineation of areal unit will produce different analysis results. The latter means using a single point to represent spatially distributed population within an areal unit. If fail to take these two problems into consideration, one may misinterpret and misestimate the accessibility values.
With the advent of finer areal unit and ancillary data become available, it is possible to pinpoint the areas that population truly reside and calculate individual-based accessibility values, then reduce and eliminate the impact of modifiable areal unit problem and aggregation error. Thus, this dissertation tries to use land use survey map to extract the residential area to represent the places that the population truly distributed and calculate individual-based accessibility values. Compare such values with zone- based accessibility values to evaluate the magnitude and quantity of aggregation error.
The result shows that even use the finest areal unit, there are still some places suffer significant and extremely large aggregation error and the spatial distribution of aggregation error is not necessarily located in some specific areas. Therefore, if possible, it is recommended to calculated individual-based accessibility values to eliminate the modifiable areal unit problem and aggregation error.		en_US
dc.description.tableofcontents 摘要 i
Abstract ii
Figures v
Tables vii
Chapter 1. Introduction 1
1.1 Research Background and Motivation 1
1.2 Research Purposes 3
1.3 Research Study area 4
Chapter 2. Literature review 7
2.1 Definition and Concept of Accessibility 7
2.2 Approaches of Measuring Accessibility 10
2.3 Limitations and Problems when Measuring Accessibility 17
2.4 Previous Researches of Investigating Aggregation Error 30
2.5 Summary of literature review 37
Chapter 3. Research Design and Methodology 39
3.1 Research workflow 39
3.2 Research design 40
3.3 Research methodology 50
Chapter 4. Research result 57
4.1 Comparison between zone-based and individual-based 57
4.2 Areal unit with significant aggregation error 69
4.3 Discussion 75
Chapter 5. Research Conclusion and Limitation 77
5.1 Research conclusions 77
5.2 Research recommendations 78
5.3 Research limitations 79
References 81		zh_TW
dc.format.extent 4217760 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0110257006en_US
dc.subject (關鍵詞) 地理可及性zh_TW
dc.subject (關鍵詞) 聚合誤差zh_TW
dc.subject (關鍵詞) 可調整區域單元問題zh_TW
dc.subject (關鍵詞) Accessibilityen_US
dc.subject (關鍵詞) Aggregation erroren_US
dc.subject (關鍵詞) Modifiable areal unit problemen_US
dc.title (題名) 比較不同人口點位對潛在醫療可及性的影響zh_TW
dc.title (題名) Comparing potential accessibility to healthcare facilities under different representations of populationen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) Apparicio, P., Abdelmajid, M., Riva, M., & Shearmur, R. (2008). Comparing alternative approaches to measuring the geographical accessibility of urban health services: Distance types and aggregation-error issues. International Journal of Health Geographics, 7(1), 7. doi:10.1186/1476-072X-7-7
Apparicio, P., Cloutier, M.-S., & Shearmur, R. (2007). The case of Montréal`s missing food deserts: Evaluation of accessibility to food supermarkets. International Journal of Health Geographics, 6(1), 4. doi:10.1186/1476-072X-6-4
Apparicio, P., Gelb, J., Dubé, A.-S., Kingham, S., Gauvin, L., & Robitaille, É. (2017). The approaches to measuring the potential spatial access to urban health services revisited: distance types and aggregation-error issues. International Journal of Health Geographics, 16(1), 32. doi:10.1186/s12942-017-0105-9
Brabyn, L., & Barnett, R. (2004). Population need and geographical access to general practitioners in rural New Zealand. N Z Med J, 117(1199), U996.
Buzzelli, M. (2020). Modifiable areal unit problem. International encyclopedia of human geography, 169.
Cartagena-Colón, M., Mattei, H., & Wang, C. (2022). Dasymetric Mapping of Population Using Land Cover Data in JBNERR, Puerto Rico during 1990–2010. Land, 11(12), 2301. Retrieved from https://www.mdpi.com/2073-445X/11/12/2301
Comber, A., & Zeng, W. (2019). Spatial interpolation using areal features: A review of methods and opportunities using new forms of data with coded illustrations. Geography Compass, 13(10), e12465. doi:https://doi.org/10.1111/gec3.12465
Crooks, V. A., & Schuurman, N. (2012). Interpreting the results of a modified gravity model: examining access to primary health care physicians in five Canadian provinces and territories. BMC Health Serv Res, 12, 230. doi:10.1186/1472-6963-12-230
Dewulf, B., Neutens, T., De Weerdt, Y., & Van de Weghe, N. (2013). Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas. BMC Family Practice, 14(1), 122. doi:10.1186/1471-2296-14-122
Fortney, J., Rost, K., & Warren, J. (2000). Comparing Alternative Methods of Measuring Geographic Access to Health Services. Health Services and Outcomes Research Methodology, 1(2), 173-184. doi:10.1023/A:1012545106828
Guagliardo, M. F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics, 3(1), 3. doi:10.1186/1476-072X-3-3
Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., & Hudson, M. (2002). What does `access to health care` mean? Journal of Health Services Research & Policy, 7(3), 186-188. doi:10.1258/135581902760082517
Hewko, J., Smoyer-Tomic, K. E., & Hodgson, M. J. (2002). Measuring Neighbourhood Spatial Accessibility to Urban Amenities: Does Aggregation Error Matter? Environment and Planning A: Economy and Space, 34(7), 1185-1206. doi:10.1068/a34171
Higgs, G. (2004). A Literature Review of the Use of GIS-Based Measures of Access to Health Care Services. Health Services and Outcomes Research Methodology, 5(2), 119-139. doi:10.1007/s10742-005-4304-7
Higgs, G., Fry, R., & Langford, M. (2012). Investigating the Implications of Using Alternative GIS-Based Techniques to Measure Accessibility to Green Space. Environment and Planning B: Planning and Design, 39(2), 326-343. doi:10.1068/b37130
Hsieh, C.-C., Liao, H.-C., Yang, M.-C., & Tung, Y.-C. (2019). 全民健康保險醫療資源潛在空間可近性分析－以台灣北部四縣市為例. [Potential spatial accessibility of health care resources: an example of four counties and cities in northern Taiwan]. Taiwan Gong Gong Wei Sheng Za Zhi, 38(3), 316-327. doi:https://doi.org/10.6288/TJPH.201906_38(3).108016
Jones, S. G., Ashby, A. J., Momin, S. R., & Naidoo, A. (2010). Spatial implications associated with using Euclidean distance measurements and geographic centroid imputation in health care research. Health Serv Res, 45(1), 316-327. doi:10.1111/j.1475-6773.2009.01044.x
Kelobonye, K., Zhou, H., McCarney, G., & Xia, J. (2020). Measuring the accessibility and spatial equity of urban services under competition using the cumulative opportunities measure. Journal of Transport Geography, 85, 102706. doi:https://doi.org/10.1016/j.jtrangeo.2020.102706
Khan, A. A. (1992). An integrated approach to measuring potential spatial access to health care services. Socio-Economic Planning Sciences, 26(4), 275-287. doi:https://doi.org/10.1016/0038-0121(92)90004-O
Langford, M., & Higgs, G. (2006). Measuring Potential Access to Primary Healthcare Services: The Influence of Alternative Spatial Representations of Population. The Professional Geographer, 58(3), 294-306. doi:10.1111/j.1467-9272.2006.00569.x
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