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Demand and level of service inflation in Floating Catchment Area (FCA) methods

机译：浮动集水区（FCA）方法中的需求和服务通胀水平

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Floating Catchment Area (FCA) methods are a popular tool to investigate accessibility to public facilities, in particular health care services. FCA approaches are attractive because, unlike other accessibility measures, they take into account the potential for congestion of facilities. This is done by 1) considering the population within the catchment area of a facility to calculate a variable that measures level of service, and then 2) aggregating the level of service by population centers subject to catchment area constraints. In this paper we discuss an effect of FCA approaches, an artifact that we term demand and level of service inflation. These artifacts are present in previous implementations of FCA methods. We argue that inflation makes interpretation of estimates of accessibility difficult, which has possible deleterious consequences for decision making. Next, we propose a simple and intuitive approach to proportionally allocate demandand and level of service in FCA calculations. The approach is based on a standardization of the impedance matrix, similar to approaches popular in the spatial statistics and econometrics literature. The result is a more intiuitive measure of accessibility that 1) provides a local version of the provider-to-population ratio; and 2) preserves the level of demand and the level of supply in a system. We illustrate the relevant issues with some examples, and then empirically by means of a case study of accessibility to family physicians in the Hamilton Census Metropolitan Area (CMA), in Ontario, Canada. Results indicate that demand and supply inflation/deflation affect the interpretation of accessibility analysis using existing FCA methods, and that the proposed adjustment can lead to more intuitive results.
机译：浮动集水区（FCA）方法是调查公共设施，特别是医疗服务的可及性的一种流行工具。 FCA方法之所以具有吸引力，是因为与其他无障碍措施不同，它们考虑了设施拥挤的可能性。这是通过以下步骤完成的：1）考虑设施集水区内的人口，以计算衡量服务水平的变量，然后2）根据受集水区限制的人口中心汇总服务水平。在本文中，我们讨论了FCA方法的效果，我们将其称为需求和服务通胀水平。这些伪像存在于FCA方法的先前实现中。我们认为通货膨胀使对可及性估计值的解释变得困难，这可能对决策产生有害影响。接下来，我们提出一种简单直观的方法来按比例分配FCA计算中的需求和服务水平。该方法基于阻抗矩阵的标准化，类似于空间统计和计量经济学文献中流行的方法。结果是对访问性的更直观的度量，即：1）提供提供者与人口比例的本地版本；和2）保留系统中的需求水平和供应水平。我们通过一些示例来说明相关问题，然后通过对加拿大安大略省汉密尔顿人口普查大都会区（CMA）的家庭医生可及性进行案例研究。结果表明，需求和供应的通货膨胀/通货紧缩会影响使用现有FCA方法进行的可及性分析的解释，并且建议的调整可以导致更直观的结果。

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