Spatial Heterogeneities in Healthcare Visits and their Socioeconomic Determinants: A Comprehensive Analysis Using Traffic Flow Data

Abstract

Spatial accessibility to healthcare is widely studied across various disciplines, primarily to identify underserved neighborhoods. Whereas most studies focus on the potential travel to healthcare facilities, few consider the actual travel people undertake. Addressing this research gap, our study explores how healthcare visits, the distance traveled, and socioeconomic determinants vary across hospital locations and types. We analyze healthcare visits as origin-to-destination flows to hospitals in Columbus, OH, using GPS-tracked mobility data. We consider three hospital types to account for services offered: general hospitals, specialty hospitals, and outpatient care facilities. We employ a spatially weighted interaction model to identify both global and local influences of distance and socioeconomic factors on healthcare visits. Overall, we observed a significant decline in healthcare visits with increasing distance, whereas socioeconomic influences appeared minor at the global level. However, the disaggregated local models found that the impacts of distance and socioeconomic factors fluctuated considerably across hospital locations and services offered. For instance, hospitals providing diverse and specialized services tended to attract visitors from all socioeconomic backgrounds and greater distances. In contrast, general hospitals and outpatient care facilities, especially suburban ones, exhibited more localized visit patterns with fewer visitors from poorer neighborhoods, whereas a few exclusively serve poorer populations. Additionally, we found that the lack of medical insurance significantly affected healthcare visits. These findings thus underscore the healthcare disparities experienced, enabling practitioners and policy makers to pinpoint the hospital locations that are less accessible to socioeconomically disadvantaged populations, ultimately informing the development of more equity-focused healthcare policies.