Information Systems Frontiers

, Volume 20, Issue 2, pp 303–309 | Cite as

Comment on “A Conceptual Framework for Quality Healthcare Accessibility: a Scalable Approach for Big Data Technologies”

  • Paul L. Delamater


ᅟFloating Catchment Area (FCA) metrics incorporate the supply of health care resources, potential population demand for those resources, and the distance separating people and supply locations to characterize the spatial accessibility of health care resources for populations. In this work, I challenge a number of assertions offered in a recently published FCA-based paper and provide a critique of the authors' proposed metric. Within my critique, I present a number of broad observations and recommendations regarding FCA metrics and their implementation in a Geographic Information System (GIS). In doing so, I aim to initiate a broader discussion of access to health care, spatial accessibility, and FCA metrics that transcends disciplinary boundaries.


Geographic information systems Health care analytics Health care accessibility Gravity models 


  1. Bell, S., Wilson, K., Bissonnette, L., & Shah, T. (2013). Access to primary health care: does neighborhood of residence matter? Annals of the Association of American Geographers, 103(1), 85–105. Scholar
  2. Dai, D., & Wang, F. (2011). Geographic disparities in accessibility to food stores in southwest Mississippi. Environment and Planning B, Planning & Design, 38(4), 659–677. Scholar
  3. Delamater, P. L. (2013). Spatial accessibility in suboptimally configured health care systems: a modified two-step floating catchment area (M2SFCA) metric. Health & Place, 24, 30–43. Scholar
  4. Delamater, P. L., Messina, J. P., Grady, S. C., WinklerPrins, V., & Shortridge, A. M. (2013). Do more hospital beds lead to higher hospitalization rates? A spatial examination of Roemer’s law. PLoS One, 8(2), e54900. Scholar
  5. Fransen, K., Neutens, T., De Maeyer, P., & Deruyter, G. (2015). A commuter-based two-step floating catchment area method for measuring spatial accessibility of daycare centers. Health & Place, 32, 65–73. Scholar
  6. Guagliardo, M. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics, 3(3), 1–13.Google Scholar
  7. Joseph, A. E., & Bantock, P. R. (1982). Measuring potential physical accessibility to general practitioners in rural areas: a method and case study. Social Science & Medicine, 16(1), 85–90. Scholar
  8. Khan, A. A. (1992). An integrated approach to measuring potential spatial access to health care services. Socio-Economic Planning Sciences, 26(4), 275–287. Scholar
  9. Kwan, M.-P. (1998). Space-time and integral measures of individual accessibility: a comparative analysis using a point-based framework. Geographical Analysis, 30, 191–216.CrossRefGoogle Scholar
  10. Langford, M., Fry, R., & Higgs, G. (2012a). Measuring transit system accessibility using a modified two-step floating catchment technique. International Journal of Geographical Information Science, 26(2), 193–214. Scholar
  11. Langford, M., Higgs, G., & Fry, R. (2012b). Using floating catchment analysis (FCA) techniques to examine intra-urban variations in accessibility to public transport opportunities: the example of Cardiff, Wales. Journal of Transport Geography, 25, 1–14. Scholar
  12. Li, Z., Serban, N., & Swann, J. L. (2015). An optimization framework for measuring spatial access over healthcare networks. BMC Health Services Research, 15(1), 273. Scholar
  13. Lin, B.-C., Chen, C.-W., Chen, C.-C., Kuo, C.-L., Fan, I., Ho, C.-K., Liu, I.-C., & Chan, T.-C. (2016). Spatial decision on allocating automated external defibrillators (AED) in communities by multi-criterion two-step floating catchment area (MC2SFCA). International Journal of Health Geographics, 15(1), 17. Scholar
  14. Luo, J. (2014). Integrating the huff model and floating catchment area methods to analyze spatial access to healthcare services. Transactions in GIS, 18(3), 436–448. Scholar
  15. 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. Scholar
  16. Luo, W., & Wang, F. (2003). Measures of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region. Environment and Planning B, Planning & Design, 30(6), 865–884. Scholar
  17. McGrail M.R., Humphreys J.S., (2014) Measuring spatial accessibility to primary health care services: Utilising dynamic catchment sizes. Applied Geography 54:182-188CrossRefGoogle Scholar
  18. McGrail, M. (2012). Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements. International Journal of Health Geographics, 11(1), 50. Scholar
  19. Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19(2), 127–140. Scholar
  20. Plachkinova, M., Vo, A., Bhaskar, R., & Hilton, B. (2018). A conceptual framework for quality healthcare accessibility: a scalable approach for big data technologies. Information Systems Frontiers, 20(2).
  21. Radke, J., & Mu, L. (2000). Spatial decompositions, modeling and mapping service regions to predict access to social programs. Annals of GIS, 6(2), 105–112. Scholar
  22. Wan, N., Zhan, F. B., Zou, B., & Chow, E. (2011). A relative spatial access assessment approach for analyzing potential spatial access to colorectal cancer services in Texas. Applied Geography, 32, 291–299.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Geography, Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillUSA

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