5267.0: Wednesday, November 15, 2000 - 4:50 PM

Abstract #14349

Assessing organ transplantation in California: A Geographic Information Systems (GIS) analysis of health care access

Karl J. McCleary, PhD, MPH, Department of Health Administration, Loma Linda University, Nichol Hall Rm. 1321, School of Public Health, Loma Linda, CA 92350, (909) 558-4300, x48879, KMcCleary@sph.llu.edu, Sam Soret, PhD, LIC, Geographic Information, Analysis, and Technologies Laboratory, Loma Linda University, Nichol Hall Rm. 1212, School of Public Health, Loma Linda, CA 92350, Patrick A. Rivers, PhD, MBA, School of Health Administration and Policy, Arizona State University, College of Business, P.O. Box 874506, Tempe, AZ 85287-4506, and Susanne B. Montgomery, PhD, MPH, Health Education & Promotion, Loma Linda University, 10970 Parkland Ave, Loma Linda, CA 92350.

In this paper we examine health care access to transplant centers through GIS tools for deriving spatial patterns of transplant recipients. Conceptually, we drew from diverse disciplinary areas, including corporate strategy, economics, and spatial analysis. We used Patient Discharge Data (1990-1997) from the State of California, Office of Statewide Health Planning and Development (OSHPD). Transplant recipients were extracted using major diagnostic categories and diagnosis related group (DRG) codes. We used visualization and smoothing techniques to reveal spatial variation of recipient distributions and patterns of dominance across the transplant center network. We used spatial autocorrelation techniques to test for patient clustering. Geographic access to organ transplantation was assessed via correlations of distance and utilization. We expect these analyses will reveal definite, nonrandom patterns of transplantation, with clustering around the larger metropolitan statistical areas (MSAs). Even after adjusting for population size, we anticipate clustering will persist around the larger MSAs due to differences in socioeconomic, demographic, and local market factors. Prominent transplant centers will tend to be located in areas with higher concentrations of knowledge workers possessing specialized competencies, competitive health care delivery systems, other transplant centers, and savvy consumers of medical services. Our findings will reveal the importance of the local proximity of such services. Clusters promote competition and cooperation for organs, increase productivity, spur innovation, and create alliances and organizational relationships. GIS is a powerful tool for analyzing the sophisticated network of organ transplantation and challenges current assumptions regarding resource flows on either side of this important policy issue.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to:

  1. Articulate innovative interdisciplinary perspectives that hold promise for understanding health care access.
  2. Identify basic exploratory geographic information systems (GIS) analysis and applications to health care access.
  3. Describe and characterize the geographic distribution patterns of organ transplant recipients within the State of California.

Keywords: Health Care Access, Geographic Information Systems

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: ARC/INFO and ArcView GIS Software
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA