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Multimodal accessibility of primary
health care and social services
Ossi Kotavaara1, Timo Pohjosenperä2
1Geography Research Unit, 2Oulu Business School
University of Oulu
Geospatial data in health and welfare research
23.10.2018 Helsinki
Low carbon logistics in local social
and health care services
BASELINE
Northern Ostrobothnia: 411 889 inhabitants
/ 391 365 reaches health center by car in 20 min
Greater* Oulu region: 261 420 inhabitants
/ 208 138 reaches health center by bus in 30 min
Travels in Oulu: 5 % bus / 16 % walk / 19 % bike /
60 % car
Oulu bus trips: 13168 / Feb 2018 / weekday 06-11
*Oulu, Kempele, Hailuoto, Ii, Liminka, Lumijoki, Muhos, Tyrnävä, Utajärvi
University of Oulu / Geography Reserach Unit / Geoinformatics
RESEARCH BACKGROUND
• The Finnish healthcare system is reorganization, new
service providers are accessing to emerging markets and
public authorities are responsible for adequate service
network.
• Adequate and equal access to services are key factors for
good-quality health care.
• Locally available services will also reduce the need for
passenger car travels and also CO² emissions, if public
transport may be easily used.
University of Oulu / Geography Reserach Unit / Geoinformatics
SERVICE ACCESSIBILITY / LOCATION-ALLOCATION
IN NORTHERN OSTROBOTHNIA
• Measuring accessibility and optimising service locations
/ GIS based computations
/ Bus and car travels
• Primary level services
/ Maternity and child health clinics / children
/ Health centres (primary health care) / all users
/ Dentits / all users
• Future needs of elderly health care
/ Emergency 24/7 and suplementary services
/ Primary health care hospitals and hospital wards
University of Oulu / Geography Reserach Unit / Geoinformatics
MEASURING TRANSPORT ACCESSIBILITY BY
GEOGRAPHIC INFORMATION SYSTEMS (GIS)
‘Accessibility... ...is the extent to which
the land-use transport system enables
(groups of) individuals or goods to reach
activities or destinations by means of a
(combination of) transport mode(s).’
Geurs & Ritseman van Eck (2001: 19)
University of Oulu / Geography Reserach Unit / Geoinformatics
ACCESSIBILITY BY CAR
ACCESSIBILITY BY PUBLIC TRANSPORT
ACCESSIBILITY BY BUS AND CAR
IN GREATER OULU REGION AND NORTHERN OSTROBOTHNIA
University of Oulu / Geography Reserach Unit / Geoinformatics
Car
Bus
BUS
TRAVELS
/
FEBRUARY
WEEKDAY
06-11 AM
AVERAGE
/
GREATER
OULU
REGION
PROFILING BUS USERS
(OULU REGION / FEBRUARY 2018)
University of Oulu / Geography Reserach Unit / Geoinformatics
User groups by age (%) (N)
Children 20,0 179 969
Youth & Students 38,8 348 807
Adults 41,1 369 264
Sum 100 898 040
Ticket types (%) (N)
Season ticket 58,3 523 528
Value ticket (card) 24,0 215 431
Single ticket 11,9 106 982
School (childred) 5,8 52 099
P-MEDIAN / MINIMIZE IMPEDANCE
/ MOST EFFICIENT TRAVEL PATTERN
• P-median (i.e. minimize impedance) reduces the overall
distance the public needs to travel to reach the chosen
facilities
• Locating facilities with minimizing the overall need of traveling
/ Minimize Impedance chooses facilities such that the sum of
weighted impedances (demand allocated to a facility multiplied by
the impedance to the facility) is minimized
/ The minimize impedance is ordinarily regarded as more equitable
than other problem types for locating some public-sector facilities
such as libraries, regional airports, museums, department of motor
vehicles offices, and health clinics.
University of Oulu / Geography Reserach Unit / Geoinformatics
INTEGRATED PUBLIC TRANSPORT AND
PASSENGER CAR LOCATION-ALLOCATION
/ Potential bus users are routed from home locations to
all potential service locations via the fastest available
transit connections within a defined time period
/ By applying this connectivity matrix with car travel
routing, public transport and car travels may be
integrated in the location-allocation analysis.
University of Oulu / Geography Reserach Unit / Geoinformatics
walk +
bus with changes
+ walk
ROUTING PUBLIC TRANSPORT AND CAR USERS
Fastest connections between
each residential and service
location
Bus travels starting on
Tue 6. Feb 2018 8:00–8:59
/ One-minute intervals
/ Realistic travel chains
/ Connectivity matrix for
location allocation
University of Oulu / Geography Reserach Unit / Geoinformatics
walk +
bus with changes
+ walk
DATA FOR CAR AND PUBLIC TRANSPORT ROUTING
• Digiroad
• Regional and local main streets,
collector and feeder streets and
private roads allowed for public
use…
• Travel speed estimates were
formulated on the basis of the
speed limit data
• General Transit Feed Specification
(GTFS) of Oulu Region public transports
• Scheduled bus connections
• Travel chains
• 4 km/h was applied for walking
• Northern Finland is mainly uncongested
 turn penalties / urban delay rates
PUBLIC TRANSPORT AND CAR TRAVEL ESTIMATES
BY HOUSEHOLD CAR OWNERSHIP DATA
Car ownership data applied in
producing raw estimates for the
public transport users
/ Share of households having no
car  will updated with bus stop
specific data
~216 000 inhabitants divided to
~ 53 000 public transports users
~ 160 000 car users
University of Oulu / Geography Reserach Unit / Geoinformatics
DEVELOPING SERVICE NETWORK BY ACCESSIBILITY
P-MEDIAN LOCATION-ALLOCATION RESULTS
Allocation by bus and car Allocation by car, all users Allocation by bus only
REFERENCES
Ahmadi-Javid, A., Seyedi, P., & Syam, S. S. (2017) A survey of healthcare facility location. Computers & Operations Research, 79,
223-263.
Baray, J., and Cliquet, G. (2013) Optimizing locations through a maximum covering/p-median hierarchical model: Maternity
hospitals in France. Journal of Business Research 66(1), 127-132.
ESRI (2012) Algorithms used by Network Analyst. [Online]
http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#//004700000053000000. [Accessed 18 Jan 2018].
Finnish Road Administration, Digiroad (2017) Description of data objects, Release 2/2017. [Online] Available from:
https://www.liikennevirasto.fi/documents/20473/236203/Data_Object_Description_2_2017_ENG.pdf [Accessed 10 Jan 2018].
Huotari, T., Antikainen, H., Keistinen, T. and Rusanen J. (2017) Accessibility of tertiary hospitals in Finland: A comparison of
administrative and normative catchment areas. Social Science & Medicine 182: 60-67.
Kotavaara, O., Hakkarainen, T., Huotari, T., Keistinen, T. and Rusanen, J. (2015) Mapping Opportunities for Enhancing Effective-
ness of Health Care System by GIS Based Ac-cessibility Analyses: Locating Core and Support Services within Long Distances in
Northern Finland. In: Proceedings of the 1st ICA European Symposium on Cartography, 2009.
Lankila, T., Kotavaara, O., Antikainen, H., Hakkarainen, T. and Rusanen, J. (2016) Sosiaali- ja terveyspalveluverkon kehityskuva
2025 – Paikkatieto- ja saavutettavuusperusteinen tarkastelu. University of Oulu. [Online] Available from:
http://www.sitra.fi/julkaisu/2016/sosiaali-ja-terveyspalveluverkon-kehityskuva-2025 [Accessed 11 Dec 2017].
McLafferty, S. L. (2003). GIS and health care. Annual review of public health 24(1), 25-42.
Mestre, A. M., and Oliveira, M. D. Barbosa-Póvoa AP (2015) Location–allocation approaches for hospital network planning under
uncertainty. European Journal of Operational Research 240(3):791–806
Miller H and Shaw S-L (2001) Geographic Information Systems for Transportation, Principles and Application. Oxford University
Press
Oulu Public Transport transit data (2017) Oulun joukkoliikenteen liikennöintidata (GTFS) [Online] Available from:
https://data.ouka.fi/data/fi/dataset/oulun-liikenteen-liikennointidata-gtfs [Accessed 2 Jan 2018].
Páez A, Scott DM & Morency C. (2012) Measuring accessibility: positive and normative implementations of various accessibility
indicators. Journal of Transport Geography 25: 141–153
Polo, G., Acosta, C. M., Ferreira, F., & Dias, R. A. (2015) Location-allocation and accessibility models for improving the spatial
planning of public health services. PLoS One 10(3).
Rodrigue, J. P., Comtois, C., and Slack, B. (2016) The geography of transport systems. Taylor & Francis.
University of Oulu / Geography Reserach Unit / Geoinformatics
CONCLUSIVE DISCUSSION OPENINGS
1. What are the key public transport modes of the near
future, affecting social and health service accessibility?
/ How the general travel pattern changes?
2. What is the probable and desirable user potential of
public transports?
/ Where? By what conditions, systems, incentives or sanctions?
3. Efficiency and equality - where is the balance in spatial
trade offs in service network coverage?
4. What are the key services needed to be locally
accessible?
University of Oulu / Geography Reserach Unit / Geoinformatics
THANKS FOR THE INTEREST!
Contact:
Ossi Kotavaara
Postdoctoral researcher
Geography Research Unit
ossi.kotavaara@oulu.fi
+358 40 727 3618
Low carbon logistics in local social
and health care services

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  • 1. Multimodal accessibility of primary health care and social services Ossi Kotavaara1, Timo Pohjosenperä2 1Geography Research Unit, 2Oulu Business School University of Oulu Geospatial data in health and welfare research 23.10.2018 Helsinki Low carbon logistics in local social and health care services
  • 2. BASELINE Northern Ostrobothnia: 411 889 inhabitants / 391 365 reaches health center by car in 20 min Greater* Oulu region: 261 420 inhabitants / 208 138 reaches health center by bus in 30 min Travels in Oulu: 5 % bus / 16 % walk / 19 % bike / 60 % car Oulu bus trips: 13168 / Feb 2018 / weekday 06-11 *Oulu, Kempele, Hailuoto, Ii, Liminka, Lumijoki, Muhos, Tyrnävä, Utajärvi University of Oulu / Geography Reserach Unit / Geoinformatics
  • 3. RESEARCH BACKGROUND • The Finnish healthcare system is reorganization, new service providers are accessing to emerging markets and public authorities are responsible for adequate service network. • Adequate and equal access to services are key factors for good-quality health care. • Locally available services will also reduce the need for passenger car travels and also CO² emissions, if public transport may be easily used. University of Oulu / Geography Reserach Unit / Geoinformatics
  • 4. SERVICE ACCESSIBILITY / LOCATION-ALLOCATION IN NORTHERN OSTROBOTHNIA • Measuring accessibility and optimising service locations / GIS based computations / Bus and car travels • Primary level services / Maternity and child health clinics / children / Health centres (primary health care) / all users / Dentits / all users • Future needs of elderly health care / Emergency 24/7 and suplementary services / Primary health care hospitals and hospital wards University of Oulu / Geography Reserach Unit / Geoinformatics
  • 5. MEASURING TRANSPORT ACCESSIBILITY BY GEOGRAPHIC INFORMATION SYSTEMS (GIS) ‘Accessibility... ...is the extent to which the land-use transport system enables (groups of) individuals or goods to reach activities or destinations by means of a (combination of) transport mode(s).’ Geurs & Ritseman van Eck (2001: 19) University of Oulu / Geography Reserach Unit / Geoinformatics
  • 8. ACCESSIBILITY BY BUS AND CAR IN GREATER OULU REGION AND NORTHERN OSTROBOTHNIA University of Oulu / Geography Reserach Unit / Geoinformatics Car Bus
  • 10. PROFILING BUS USERS (OULU REGION / FEBRUARY 2018) University of Oulu / Geography Reserach Unit / Geoinformatics User groups by age (%) (N) Children 20,0 179 969 Youth & Students 38,8 348 807 Adults 41,1 369 264 Sum 100 898 040 Ticket types (%) (N) Season ticket 58,3 523 528 Value ticket (card) 24,0 215 431 Single ticket 11,9 106 982 School (childred) 5,8 52 099
  • 11. P-MEDIAN / MINIMIZE IMPEDANCE / MOST EFFICIENT TRAVEL PATTERN • P-median (i.e. minimize impedance) reduces the overall distance the public needs to travel to reach the chosen facilities • Locating facilities with minimizing the overall need of traveling / Minimize Impedance chooses facilities such that the sum of weighted impedances (demand allocated to a facility multiplied by the impedance to the facility) is minimized / The minimize impedance is ordinarily regarded as more equitable than other problem types for locating some public-sector facilities such as libraries, regional airports, museums, department of motor vehicles offices, and health clinics. University of Oulu / Geography Reserach Unit / Geoinformatics
  • 12. INTEGRATED PUBLIC TRANSPORT AND PASSENGER CAR LOCATION-ALLOCATION / Potential bus users are routed from home locations to all potential service locations via the fastest available transit connections within a defined time period / By applying this connectivity matrix with car travel routing, public transport and car travels may be integrated in the location-allocation analysis. University of Oulu / Geography Reserach Unit / Geoinformatics walk + bus with changes + walk
  • 13. ROUTING PUBLIC TRANSPORT AND CAR USERS Fastest connections between each residential and service location Bus travels starting on Tue 6. Feb 2018 8:00–8:59 / One-minute intervals / Realistic travel chains / Connectivity matrix for location allocation University of Oulu / Geography Reserach Unit / Geoinformatics walk + bus with changes + walk
  • 14. DATA FOR CAR AND PUBLIC TRANSPORT ROUTING • Digiroad • Regional and local main streets, collector and feeder streets and private roads allowed for public use… • Travel speed estimates were formulated on the basis of the speed limit data • General Transit Feed Specification (GTFS) of Oulu Region public transports • Scheduled bus connections • Travel chains • 4 km/h was applied for walking • Northern Finland is mainly uncongested  turn penalties / urban delay rates
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  • 16. PUBLIC TRANSPORT AND CAR TRAVEL ESTIMATES BY HOUSEHOLD CAR OWNERSHIP DATA Car ownership data applied in producing raw estimates for the public transport users / Share of households having no car  will updated with bus stop specific data ~216 000 inhabitants divided to ~ 53 000 public transports users ~ 160 000 car users University of Oulu / Geography Reserach Unit / Geoinformatics
  • 17. DEVELOPING SERVICE NETWORK BY ACCESSIBILITY P-MEDIAN LOCATION-ALLOCATION RESULTS Allocation by bus and car Allocation by car, all users Allocation by bus only
  • 18. REFERENCES Ahmadi-Javid, A., Seyedi, P., & Syam, S. S. (2017) A survey of healthcare facility location. Computers & Operations Research, 79, 223-263. Baray, J., and Cliquet, G. (2013) Optimizing locations through a maximum covering/p-median hierarchical model: Maternity hospitals in France. Journal of Business Research 66(1), 127-132. ESRI (2012) Algorithms used by Network Analyst. [Online] http://help.arcgis.com/en/arcgisdesktop/10.0/help/index.html#//004700000053000000. [Accessed 18 Jan 2018]. Finnish Road Administration, Digiroad (2017) Description of data objects, Release 2/2017. [Online] Available from: https://www.liikennevirasto.fi/documents/20473/236203/Data_Object_Description_2_2017_ENG.pdf [Accessed 10 Jan 2018]. Huotari, T., Antikainen, H., Keistinen, T. and Rusanen J. (2017) Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas. Social Science & Medicine 182: 60-67. Kotavaara, O., Hakkarainen, T., Huotari, T., Keistinen, T. and Rusanen, J. (2015) Mapping Opportunities for Enhancing Effective- ness of Health Care System by GIS Based Ac-cessibility Analyses: Locating Core and Support Services within Long Distances in Northern Finland. In: Proceedings of the 1st ICA European Symposium on Cartography, 2009. Lankila, T., Kotavaara, O., Antikainen, H., Hakkarainen, T. and Rusanen, J. (2016) Sosiaali- ja terveyspalveluverkon kehityskuva 2025 – Paikkatieto- ja saavutettavuusperusteinen tarkastelu. University of Oulu. [Online] Available from: http://www.sitra.fi/julkaisu/2016/sosiaali-ja-terveyspalveluverkon-kehityskuva-2025 [Accessed 11 Dec 2017]. McLafferty, S. L. (2003). GIS and health care. Annual review of public health 24(1), 25-42. Mestre, A. M., and Oliveira, M. D. Barbosa-Póvoa AP (2015) Location–allocation approaches for hospital network planning under uncertainty. European Journal of Operational Research 240(3):791–806 Miller H and Shaw S-L (2001) Geographic Information Systems for Transportation, Principles and Application. Oxford University Press Oulu Public Transport transit data (2017) Oulun joukkoliikenteen liikennöintidata (GTFS) [Online] Available from: https://data.ouka.fi/data/fi/dataset/oulun-liikenteen-liikennointidata-gtfs [Accessed 2 Jan 2018]. Páez A, Scott DM & Morency C. (2012) Measuring accessibility: positive and normative implementations of various accessibility indicators. Journal of Transport Geography 25: 141–153 Polo, G., Acosta, C. M., Ferreira, F., & Dias, R. A. (2015) Location-allocation and accessibility models for improving the spatial planning of public health services. PLoS One 10(3). Rodrigue, J. P., Comtois, C., and Slack, B. (2016) The geography of transport systems. Taylor & Francis. University of Oulu / Geography Reserach Unit / Geoinformatics
  • 19. CONCLUSIVE DISCUSSION OPENINGS 1. What are the key public transport modes of the near future, affecting social and health service accessibility? / How the general travel pattern changes? 2. What is the probable and desirable user potential of public transports? / Where? By what conditions, systems, incentives or sanctions? 3. Efficiency and equality - where is the balance in spatial trade offs in service network coverage? 4. What are the key services needed to be locally accessible? University of Oulu / Geography Reserach Unit / Geoinformatics
  • 20. THANKS FOR THE INTEREST! Contact: Ossi Kotavaara Postdoctoral researcher Geography Research Unit ossi.kotavaara@oulu.fi +358 40 727 3618 Low carbon logistics in local social and health care services