11/25/2011 LAYOUT GIS Applications in Health Systems

11/25/2011
LAYOUT
GIS Applications in
Health Systems
Research
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Introduction to GIS
Defining GIS
Health and GIS
Research areas in
Health with Examples
Dr. P.V.D.S. Dharmagunawardene
MD Medical Administration Part II
Trainee
GIS – What is it?
• Geographic/Geospatial Information
– information about places on the
earth’s surface
– knowledge about
“what is where when”
Geographic/geospatial: synonymous
• GIS--what’s in the S?
– Systems: the technology
– Science: the concepts & theory
– Studies: the societal context
Defining GIS
• The common ground between information processing and
the many fields using spatial analysis techniques.
(Tomlinson, 1972)
• A powerful set of tools for collecting, storing, retrieving,
transforming, and displaying spatial data from the real
world. (Burroughs, 1986)
• A computerized database management system for the
capture, storage, retrieval, analysis and display of spatial
(locationally defined) data. (NCGIA, 1987)
• A decision support system involving the integration of
spatially referenced data in a problem solving
environment. (Cowen, 1988)
Geographic Information Technologies
• Global Positioning Systems (GPS)
GPS and RS are
– a system of earth-orbiting satellites which can sources of input
provide precise (100 meter to sub-cm.) location data for
on the earth’s surface (in latitude/longitude
a GIS
coordinates or equiv.)
• Remote Sensing (RS)
– use of satellites or aircraft to capture
information about the earth’s surface
• Geographic Information Systems (GIS)
– Software systems with capability for input,
storage, manipulation/analysis and
output/display of geographic (spatial)
information
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A GIS provides for storing and manipulating GPS and RS data.
Comprehensive Definition for GIS
A system of integrated computer-based tools for
end-to-end processing (capture, storage, retrieval,
analysis, display) of data using location on the
earth’s surface for interrelation in support of
operations management, decision making and
scientific inquiries.
• set of integrated tools for spatial analysis
• encompasses end-to-end processing of data
– capture, storage, retrieval, analysis/modification, display
• uses explicit location on earth’s surface to relate data
• aimed at decision support, as well as on-going operations and
scientific inquiry
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Examples of Applied GIS
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Urban Planning, Management &
Policy
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Monitoring environmental risk
Modeling stormwater runoff
Management of watersheds,
floodplains, wetlands, forests, aquifers
Environmental Impact Analysis
Hazardous or toxic facility siting
Groundwater modeling and
contamination tracking
Political Science
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Redistricting
Analysis of election results
Predictive modeling
Civil Engineering/Utility
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Attendance Area Maintenance
Enrollment Projections
School Bus Routing
Real Estate
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Demographic Analysis
Market Penetration/ Share Analysis
Site Selection
Education Administration
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Locating underground facilities
Designing alignment for freeways, transit
Coordination of infrastructure
maintenance
Business
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Environmental Sciences
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Zoning, subdivision planning
Land acquisition
Economic development
Code enforcement
Housing renovation programs
Emergency response
Crime analysis
Tax assessment
GIS & HEALTH – HISTORY
Neighborhood land prices
Traffic Impact Analysis
Determination of Highest and Best Use
Health Care
– Epidemiology
– Service Inventory and Analysis
– Needs Analysis
SPOT MAPS
1854 – London Cholera Epidemic
Dr. John Snow Map
GIS & HEALTH – RESEARCH AREAS
1. Description of spatial patterns of morbidity and
mortality, factors associated with these patterns,
disease diffusion and disease aeitilogy
2. The spatial distribution, location diffusion and
regionalization of health care resources, access
to utilization of resources and factors related to
resource distribution and use
3. Spatial aspects of the interactions between
disease and health care delivery
1. Description of
Spatial Patterns of
Morbidity and
Mortality,
Factors Associated
with these Patterns,
Disease Diffusion and
Disease Aeitilogy
EPIDEMIOLOGY
EPIDEMIOLOGY OF
HAEMODIALYSING
END STAGE RENAL FAILURE
(ESRF) PATIENTS IN NORTH
CENTRAL PROVINCE (NCP)
OF SRI LANKA
Dr. P.V.D.S. Dharmagunawardene
Medical Superintendent – Base Hospital – Dambadeniya
Mrs. H.M.J.R. Herath
Senior Lecturer – Department of Geography – University of Sri
Jayewardenepura
Dr. M.A.L.R. Perera
Senior Consultant in Health System Management – Finance Commission
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Geographical
Distribution
of ESRF
patients in
NCP by
Divisional
Secretariat
(DS)
Divisions
Prevalence and
Geographical
Distribution of
ESRF patients in
NCP
and Relationship
with Fluoride
Levels in Soil and
Fluoride Soil Map
of Sri Lanka
Average Fluoride Levels
(Parts Per Million)
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4
3.5
3
2.5
2
1.5
1
0.5
0
0
50
Prevalence of
y = 0.0104x + 1.6579
ESRF in NCP
R² = 0.2907
and Relationship
with Fluoride
100
150
200
Levels in Soil
Average Fluoride Levels
(Parts Per Million)
Prevalence of ESRF – U (Patients Per Million)
Substantial
relationship between
soil Fluoride levels
and prevalence of
ESRF – U
3.5
3
2.5
2
1.5
1
0.5
0
y = 0.0047x + 1.8715
R² = 0.0705
Minimal
relationship with the
0
50
100
150 prevalence of ESRF
15
–K
Prevalence of ESRF – K (Patients per Million)
LOCATION OF NEW
LABORATORIES IN NORTH
WESTERN PROVINCE (NWP)
OF SRI LANKA
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2. The Spatial Distribution,
Location Diffusion and
Regionalization of
Health Care Resources,
Access to Utilization of
Resources and
Factors Related to
Resource Distribution and Use
SERVICE INVENTORY / ANALYSIS
Location of
Health Care
Institutions in
Dr. R.M.S.K Rathnayake
Provincial Director of Health Services – NWP
North Western
Province
Dr. P.V.D.S. Dharmagunawardene
Medical Superintendent – Base Hospital – Dambadeniya
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10 Km Service
Location of
Areas of Base and
Probable Health
District Hospitals
Care Institutions
in North Western
for Provision of
Province, Where
Laboratory
Existing
Facilities in North
Laboratories
Western Province
Analysis of Location Efficiency
3. Spatial Aspects of
the Interactions
between Disease and
Health Care Delivery
NEED ANALYSIS
/ LOCATION
ALLOCATION
• Location efficiency is defined as the ratio of
actual performance (the average distance to
the closest existing health services site) to
optimal performance (the average distance
to the closest optimal health service site
selected by the Location Allocation Model)
Location Allocation Model
Graphical Representation of Concepts
• A location-allocation model is a method for finding
optimal sites for facility locations. (Optimal Performance)
CRITERIA – Head Injury Patient should reach A
Health Care Institution with 24 Hour CT Scan
Facilities within 6 Hours of the Injury
Travel Time should be 3 Hours
• The method involves simultaneously selecting a set of
locations for facilities and
assigning spatially distributed sets of demands to these
facilities
to optimize some specified measurable criterion.
• 3 Basic Elements
– Demand – Spatial distribution of identified location criteria
– Service Centre – Spatial Data on existing health
infrastructure
– Network – Connection between demand and service centres
DEMAND
SERVICE CENTRE
240 Km = 6 hours
NETWORK
ACTUAL
LOCATION OF
THE HEALTH
CARE
INSTITUTION
OPTIMAL
LOCATION OF
THE HEALTH
CARE
INSTITUTION
LOCATION EFFICIENCY = 50%
120 Km = 3 hours
BUFFER
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EXAMPLE
HEALTH SERVICE DEMAND
HEALTH SERVICE LOCATIONS
RESULTS – LOCATION EFFICIENCY
LOCATION EFFICIENCY OF
PHC IN 1981 = 0.89
LOCATION EFFICIENCY OF
PHC IN 1991 = 0.85
LOCATION EEFICIENCY OF
PHC IN 1996 = 0.83
RESULTS – LOCATION ALLOCATION MODEL
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