An evaluation of ambulance service performance using a Geographic Information System

The accessibility, distribution and utilization of emergency health care services have a great impact on the effectiveness, efficiency and equity of health service delivery. The impact of these factors is heightened by the fact that ambulance resources, which are an important component of emergency health care, are often insufficient, resulting in performances below those required to respond reliably to emergency calls from demand areas. Measures of realized geographic accessibility of ambulances to call locations are of considerable importance in planning the deployment of this service as they allow planners to account for response time variations, often caused when ambulances are not available at the station closest to a call. However, the current body of related research does not adequately address important spatio-temporal analytical issues that are the result of this variation in response performance, for assessing realized geographic accessibility. This thesis examines these analytical deficiencies in order to assist emergency health service planners and decision-makers improve accessibility and response performance to target populations. Towards this end, it examines issues related to assessing accessibility for emergency health-care service delivery. It also examines the current use of Geographic Information System (GIS) technology to improve service delivery. An analytic model and GIS design framework is developed in order to provide a conceptual framework for assessing realized geographic accessibility. Further, it develops statistical and geographical modeling methods and outputs into a GIS-based application, to operationalize the analytical model and GIS design framework. In this context, a design methodology is proposed to develop a user-centred, task-based Graphical User Interface (GUI) to facilitate the navigation of a user through the components of the application in a decision support environment. The research methodology is applied to evaluate the usefulness of the application and its approach with a case study using empirical data from the Ontario Ministry of Health

GIS and urban design

Although urban planning has used computer models and information systems sincethe 1950s and architectural practice has recently restructured to the use of computeraideddesign (CAD) and computer drafting software, urban design has hardly beentouched by the digital world. This is about to change as very fine scale spatial datarelevant to such design becomes routinely available, as 2dimensional GIS(geographic information systems) become linked to 3dimensional CAD packages,and as other kinds of photorealistic media are increasingly being fused with thesesoftware. In this chapter, we present the role of GIS in urban design, outlining whatcurrent desktop software is capable of and showing how various new techniques canbe developed which make such software highly suitable as basis for urban design.We first outline the nature of urban design and then present ideas about how varioussoftware might form a tool kit to aid its process. We then look in turn at: utilisingstandard mapping capabilities within GIS relevant to urban design; buildingfunctional extensions to GIS which measure local scale accessibility; providingsketch planning capability in GIS and linking 2-d to 3-d visualisations using low costnet-enabled CAD browsers. We finally conclude with some speculations on thefuture of GIS for urban design across networks whereby a wide range of participantsmight engage in the design process digitally but remotely

Spatial accessibility and social inclusion: The impact of Portugal's last health reform

Health policies seek to promote access to health care and should provide appropriate geographical accessibility to each demographical functional group. The dispersal demand of health‐careservices and the provision for such services atfixed locations contribute to the growth of inequality intheir access. Therefore, the optimal distribution of health facilities over the space/area can lead toaccessibility improvements and to the mitigation of the social exclusion of the groups considered mostvulnerable. Requiring for such, the use of planning practices joined with accessibility measures. However,the capacities of Geographic Information Systems in determining and evaluating spatial accessibility inhealth system planning have not yet been fully exploited. This paper focuses on health‐care services planningbased on accessibility measures grounded on the network analysis. The case study hinges on mainlandPortugal. Different scenarios were developed to measure and compare impact on the population'saccessibility. It distinguishes itself from other studies of accessibility measures by integrating network data ina spatial accessibility measure: the enhanced two‐stepfloating catchment area. The convenient location forhealth‐care facilities can increase the accessibility standards of the population and consequently reducethe economic and social costs incurred. Recently, the Portuguese government implemented a reform thataimed to improve, namely, the access and equity in meeting with the most urgent patients. It envisaged,in terms of equity, the allocation of 89 emergency network points that ensured more than 90% of thepopulation be within 30 min from any one point in the network. Consequently, several emergency serviceswere closed, namely, in rural areas. This reform highlighted the need to improve the quality of the emergencycare, accessibility to each care facility, and equity in their access. Hence, accessibility measures becomean efficient decision‐making tool, despite its absence in effective practice planning. According to anapplication of this type of measure, it was possible to verify which levels of accessibility were decreased,including the most disadvantaged people, with a larger time of dislocation of 12 min between 2001 and 2011

A methodology for the incorporation of social inclusion into transport policy

4-8 July 2004. Istanbul, Turke

A Methodology to Evaluate Accessibility to Bus Stops as a Contribution to Improve Sustainability in Urban Mobility

Walking and transit are the backbone of sustainable mobility. Bus stops not only represent the connection between the two, but are also central in dictating the attractiveness of the latter. Accessibility of bus stops becomes, then, pivotal in increasing both attractiveness and sustainability of public transport. The paper describes a multi-step methodology to evaluate bus stops’ accessibility starting from a cluster of seven indicators describing objective and subjective features influencing passengers’ choice toward a given bus stop. The indicators are weighed by a questionnaire submitted to experts. Finally, a multicriteria analysis is developed to obtain a final score describing univocally the accessibility of each stop. Outcomes are mapped and a case study in Rome is reported as an example, with 231 bus and tram stops assessed accordingly. Results shows the relevance of the urban network and environment in evaluating the accessibility and in promoting more sustainable mobility patterns. Research innovation relies on the possibility to merge data from different fields into a specific GIS map and easily highlight for each bus stop the relationships between built environment, passengers’ comfort, and accessibility, with the concluding goal to provide advanced knowledge for further application

Strategic assessment of transport infrastructure Plans on European integration. Application for the Spanish Strategic Transport and Infrastructure Plan 2005-2020

Traditional transport infrastructure assessment methodologies rarely include the full range of strategic benefits for the transportation system. One of these benefits is the contribution to cross-border integration. However, this is a key issue in strategic planning and decision-making processes, as its inclusion may increase the probability of large-scale transport infrastructure projects being funded. This paper presents a methodology for the measurement of the contribution of Transport Infrastructure Plans to cross-border integration. The methodology is based on the measurement of the improvement in network efficiency in cross-border regions of neighboring countries, via accessibility calculations in a Geographical Information System (GIS) support. The methodology was tested by applying it to the ambitious road and rail network extensions included in the Spanish Strategic Transport and Infrastructure Plan (PEIT) 2005-2020. The results show significant and important network efficiency improvements of the PEIT outside the Spanish border. For the road mode, while the Spanish average accessibility improvement accounts for 2.6%, average improvements in cross-border regions of France and Portugal are of 1.8%. And for the rail mode, the corresponding Spanish value is 34.5%, whereas in neighboring regions it accounts for 20.2%. These results stress the significant importance of this strategic benefit and the consequent need for its inclusion in strategic planning processes. Finally, the paper identifies the potential of the methodology when applied at different administrative levels, such as the local or state levels

Evaluating spatial and social inequality by using GIS to analyze the catchment area and capacity of preschools in Ghent, Belgium

The growing popularity of the city as a qualitative living environment has an explicit and distinct impact on all regional cities in Flanders (Belgium). As a result of the pressure exerted by the increase in population, different kinds of spatial and social inequality can be perceived for multiple urban functions, for example for the educational system. Pupils of primary schools (in Flanders children between the age of 2.5 and 12 years) living in densely populated areas characterised by a capacity shortage in education are forced to attend schools at greater distances, because the capacity of nearby schools is exceeded. As a consequence, parents setting up camp in front of the school gates during enrolment periods are an annually recurring phenomenon. Methods pinpointing areas where problems concerning capacity are to be expected are missing. The research at hand used two different methods (short-term and long-term) to analyse the pressure exerted on preschools as a result of the growing urban population. The first analysis researched the change in capacity needs of preschools taking into account the rise of the number of children between the ages of 2 and 5 years to be expected over the next two years. The second analysis predicted the impact of urban growth on the accessibility to preschools. Instead of prognoses in overall population growth, the supply of new housing units from 2013 till 2025 was used to predict the rise in the number of children between the ages of 2.5 and 5.5 years for the next decade. Both analyses were validated for pre-schools in the city of Ghent, Flemish Region, Belgium and proved to be valuable tools to support local policy in education. The results indicated areas with considerable capacity and accessibility problems, on the short term as well as on the long term