In fact the RAWP The size and shape of a catchment area will depend on how accessible a facility is and how far it is from alternative facilities. Select a purchase HPSRs G and H accounted for 55,6% of admissions. The second part is a narrative description of issues related to each stage, and information to help the reader understand how each stage is connected to the preceding and subseque… Data used in this map are as of 9/30/2010. 9. We used malaria-related visits because we wanted to include all users of malaria-related services, not only confirmed cases. A final consideration is whether the catchment area should be based on all admissions to the facility or on the utilization of a particular service. The definition of the hospital catchment area and its population as a denominator for the evaluation of hospital returns in developing countries. Improved malaria case management through the implementation of a health facility-based sentinel site surveillance system in Uganda. the history and philosophy of statistics and the interaction of statistics with To derive catchment areas based on the road network distance, we used road distances of 5, 10, 20 and 30 km along the road networks surrounding each facility. For example, the catchment area and its population were largest when a straight-line distance of 30 km was used; consequently, the denominator was also large. The catchment area of a health-care facility is used to assess health service utilization and calculate population-based rates of disease. The journal also The cumulative case ratio approach to defining catchment areas we propose identified administrative units in which the utilization of a health-care facility was substantially lower than expected, thus enabling those units to be excluded from the facility’s catchment area. aserrano@pssjd.org. Learn More. For example, a school catchment area is the geographic area from which students are eligible to attend a local school.. The initiative was intended to support primary data collection efforts to better define and describe cancer center catchment areas using a multilevel population health framework. Fig. The catchment area included all parishes that fell within circles centred on the facility with radii of 5, 10, 20 and 30 km, respectively. Current approaches for catchment definition have significant limitations such as being based solely on distance from the facility or using an arbitrary threshold for inclusion. An unexplored aspect of FCA metrics is whether they can be useful in predicting where people actually seek care. Health centers These facilities are intended to serve as primary care centers, with urban health centers serving catchment popula-tions between 30,000 and 50,000 and rural health centers serving catchment areas of approximately 10,000 people or a radius of 29 kilometers. rural maternity or critical care); and c) changes in catchment definition and population served when a hospital and/or service is removed or added. However, an arbitrary threshold is usually imposed on the minimum proportion of patients who must come from a particular area for it to be included in the catchment area. Catchment populations per hospital ranged in size from 60977 in HPSR-B to 271047 in HPSR-H. 19. The Statistician joined the Journal of the Royal Statistical Boscoe FP, Henry KA, Zdeb MS. A nationwide comparison of driving distance versus straight-line distance to hospitals. The PCA would entail provision of nutritional However, lower than expected utilization could have been due to a low incidence of symptoms characteristic of malaria in the parish. 20. The service unit is required to provide or arrange service for every area resident in need. JSTOR®, the JSTOR logo, JPASS®, Artstor®, Reveal Digital™ and ITHAKA® are registered trademarks of ITHAKA. on malaria-related visits. Strategic Health Asset Planning and Evaluation (SHAPE) is a web enabled, evidence based application that informs and supports the strategic planning of services and assets across a whole health economy. Jan-Dec 2020;27(1):1073274820983026. doi: … Introduction. Health facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers.The number and quality of health facilities in a country or region is one common measure of that area's prosperity and quality of life. Wiley has partnerships with many of the world’s leading societies and publishes over 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols in STMS subjects. The largest geographical area was obtained using a straight-line distance of 30 km, whereas the smallest was obtained using the cumulative case ratio. If the purpose of defining a catchment area is to estimate a facility’s utilization rate, this assumption may not be of concern since areas of low utilization are excluded. To derive catchment areas based on straight-line distance, we used distances of 5, 10, 20 and 30 km. Aim 1: Identify and investigate key biobehavioral and socioenvironmental … The analysis and assessment led to the creation of a catchment area wide coalition that used the results to formulate a comprehensive strategic plan to address the barriers in the region. Series D (The Statistician) We selected six sites to represent the diversity of malaria epidemiology in Uganda. statistical computing and all aspects of statistics in sport. The figure also shows the locations of the six facilities and the variation in disease burden and geographical spread. Different approaches to defining catchment areas have been developed, mostly in the field of health service research. This study was supported by doctoral awards from the International Development Research Centre in Ottawa, Canada and by the Fonds de recherche Santé, Montréal, Canada. This is due mainly to the constraints imposed by the limitations in the available data. Hospital and Health Service facility profiles Find a health care facility by name (alphabetical list below) or Hospital and Health Service (list on the left). Accurate identification of a facility’s catchment area is important for: understanding the population served; for planning and evaluating service delivery, including the accessibility of services; and for deriving population-based health indicators, such as disease burden. JSTOR provides a digital archive of the print version of The Statistician. Access supplemental materials and multimedia. The Cancer Control and Population Health (CPH) program promotes population health sciences research focused on cancer prevention, access to optimal and effective treatment, and support of cancer survivors. temporary health facilities (THF) in Al Marawah, AZ Zaidiah and Zabid districts of Al Hodeida governorate, covering a catchment population of 151,731. a. Surveillance Lab, Clinical and Health Informatics Research Group, McGill University, 1040 Pine Avenue West, Montreal, Quebec, Canada H3A 1A3.b. option. Modelling catchment scenarios can be used to illustrate a) the percentage of denominator population that is outside of a one, two or four hour catchment; b) variations in service coverage when specific groupings of services are considered (e.g. Garnick DW, Luft HS, Robinson JC, Tetreault J. A grid cell is assigned to a facility’s catchment area if it is closer to that facility than to any other. for 1,704 (68%) of primary care facilities. Their use and interpretation has often been a source of debate. Appropriate measures of hospital market areas. Authorized users may be able to access the full text articles at this site. Similarly, if we have reported cases of disease, such as the number of cases of … Articles reflect current research by statisticians aims to bridge the gap between statistical theory and practice and to provide MHS is an integrated healthcare delivery system comprised of four advanced care hospitals, … A comprehensive facility survey instrument called the Service Provision Assessment (SPA) has been developed by USAID and Macro International Inc. to be used with nationally representative samples of health facilities to provide information on the characteristics of health services, including their quality, infrastructure, utilization and availability. Author information: (1)Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain. area [a´re-ah] (pl. In the USA, hospital service areas allow analysis of health outcomes in the population served by specific hospital or networks.3 In the UK, a number of different methods have been used to calculate hospital catchment populations (HCPs) for adults,4 of which the most widely used is the proportionate flow method used by Public Health England (PHE).5 6 However, the marked differences in referral … The surveillance programme was implemented in a staggered fashion: it started in July 2006 and the final site opened in August 2008. The denominator was the total population of all parishes included in the catchment area, which was derived using population estimates from the 2002 Uganda Population and Housing Census. For a research center that has not determined a catchment area, some considerations for defining the catchment area include: a fixed distance about the facility; a fixed travel time around the … The findings, interpretations, and conclusions expressed here are those of the authors and do not necessarily reflect the views of any of the funders, the Board of Executive Directors of the World Bank or the governments they represent. Catchment areas were plotted on mapping files obtained from the Uganda Bureau of Statistics and the geographical coordinates of all parishes were recorded using zone 35 north of the Universal Transverse Mercator coordinate system. intrinsic component of scientific endeavor. We used US adult transplant listings (2006–2016) and Dartmouth Atlas catchment areas to assess the optimal method of defining TRRs. Knowing the size of the population served by a health facility enables us to calculate statistics such as the number of physicians per capita, a measure of service provision. Kate Zinszer, a. Katia Charland, a. Ruth Kigozi, b. Corresponding Author. Federal Health Care Map This map shows Federal health care facilities from the Departments of Defense, Health and Human Services, Homeland Security, and Veterans Affairs for the United States, Philippines, and select island areas. Malaria-related visits included all visits between 1 January 2010 and 31 December 2012 by patients who had suspected or confirmed malaria or who tested negative for the disease. Floating Catchment Area (FCA) metrics provide a comprehensive measure of potential spatial accessibility to health care services and are often used to identify geographic disparities in health care access. planning. Another consideration is the time period during which the catchment area is defined since catchment areas are affected by factors that vary over time, such as changes in the capacity of or the services provided by the facility or the opening or closing of other health-care facilities nearby. These distances were selected because the 2009 Uganda Malaria Indicator Survey11 found that 96% of respondents lived within 9 km of a health-care facility and because the 2009 Uganda National Household Survey12 reported that the average distance of a household from a government hospital was 20 km. Data were collected from residents aged over 30 years (n = 997) using standardized tools and clinical measures. With a growing open access offering, Wiley is committed to the widest possible dissemination of and access to the content we publish and supports all sustainable models of access. Decentralization of financial and logistic resource management has been implemented universally. Over 40% of parishes had a cumulative case rate of 1 per 1000 or less in 2012. Serrano-Blanco A(1)(2)(3), Rubio-Valera M(4)(5)(6), Aznar-Lou I(4)(5), Baladón Higuera L(7)(8), Gibert K(9), Gracia Canales A(10), Kaskens L(10), Ortiz JM(7), Salvador-Carulla L(11). 2 demonstrates, this can result in catchment areas made up of noncontiguous parishes. Focus Issue on the Population Health Assessment in Cancer Center Catchment Areas initiative in Cancer Epidemiology, Biomarkers & Prevention. They were all government, level-IV health centres that provided care free of charge, including diagnostic testing and medications, as has been described previously, We determined which parishes should be included in the catchment area of each facility using three different parameters: the straight-line distance from the facility, the road network distance from the facility and the cumulative case ratio for malaria-related visits. Knowledge of a health-care facility's catchment area is important for assessing health service utilization, for calculating population-based rates of disease and for performing other important analyses. a. The This visualization shows the three catchment areas compared throughout the blogpost and the population cells they contain. You can find a list of contacts for Hospital and Health Boards or Services here . The number of health facilities per population of 10,000 or the number of health facilities per total population living in a designated area. Einstein is the medical school for the Montefiore Health System (MHS). The catchment area of the Aduku health-care facility did not contain any parishes when defined using a road network distance of 5 km (i.e. Different approaches to defining catchment areas have been developed, mostly in the field of health service research.1–5 One simple way of establishing the boundaries of a catchment area is to use distance from the facility – either the straight-line distance, the distance patients have to travel or the distance travelled by patients in a given time.6,7 Under this approach it is assumed that people will visit the closest facility, which implies that distance is the overriding factor influencing attendance. Population health approaches prioritize reducing health inequalities, promoting partnerships and public health initiatives, and maximizing the application of technology to strengthen health systems. However, there remain specific health programs that were initiated as vertical programs and that … Other important themes include countries in the collection of data to monitor and evaluate population, health, and nutrition programs. The survey was funded by the government of Bangladesh and United States Agency for International Development (USAID). All Rights Reserved. Then, for each facility, we compare the cumulative rate of confirmed malaria cases in the catchment area derived using this approach with the rate in areas derived using the straight line or road network distance from the facility. A population-based catchment area cross sectional survey was conducted in Kerala, India. a. Surveillance Lab, Clinical and Health Informatics Research Group, McGill University, 1040 Pine Avenue West, Montreal, Quebec, Canada H3A 1A3. It will also have two general beds for monitoring patients for 24 hours with a view to discharging them or referring … Fig 6. Health posts Series D (The Statistician), Read Online (Free) relies on page scans, which are not currently available to screen readers. ed from observed care patterns. alter the catchment population of the health facilities of the areas in which they settle, but also causes competition for the available health services with the indigenous population (MSF, 1997 a). Schuurman N, Fiedler RS, Grzybowski SC, Grund D. Defining rational hospital catchments for non-urban areas based on travel-time. Determining health-care facility catchment areas in Uganda using data . Society as its Series D from the journal of the Institute A virtual meeting was held on March 20, 2020 to enable cancer centers to share best practices around conceptualizing and conducting cancer center catchment area assessments. The Population Health Assessment in Cancer Center Catchment Areas supplemental funding initiative was intended to support a requirement instituted by NCI in 2012, wherein applicants to the Cancer Center Support Grant (CCSG) Funding Opportunity Announcement (FOA) were required to identify and describe their catchment areas and document research that specifically addresses the cancer burden, risk … Fig. E-mail address: kelly.blake@nih.gov. Coverage of remote tribal areas was found to be poor, a large number of positions lay vacant, the … (Submitted: 27 May 2013 – Revised version received: 08 October 2013 – Accepted: 21 October 2013 – Published online: 10 January 2014. Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. New city partners will be announced in 2021. Applications are invited for a full-time behavioral researcher at the level of Associate Professor/Professor to head the new Division of Health Behavior Research and Implementation Science in the Department of Epidemiology and Population Health (DEPH) at the Albert Einstein College of Medicine and to lead community … Some themes The catchment area must be population based, using census tracts, zip codes, county or state lines or geographically defined boundaries, and it must include the local area surrounding the cancer center. Planning inputs include information and data about the service catchment, its population, their socioeconomic and health status and health needs. Hospital catchment was defined as population residing in areas less than 2 hours of travel time to the next major hospital. As Fig. Consequently, the reductions in catchment areas tend to have positive impacts on accessibility for locations close to healthcare facilities but negative impacts for those locations farther away from … The data collected for each patient presenting to outpatient clinics included the patients’ demographic characteristics and parish of residence, the results of malaria diagnostic tests, the diagnosis and the treatments prescribed. Functional areas and lobes of the … The electronic version of The Statistician is available at http://www.interscience.wiley.com. During 2017 and 2018, the Dartmouth-Hitchcock Norris Cotton Cancer Center (Norris Cotton), an NCI-Designated Comprehensive Cancer Center, conducted a survey-based population health needs assessment to identify the cancer prevention and control needs of its catchment area of New Hampshire and Vermont.Because about 40% of the catchment area’s population lives in rural areas, the needs … Knowledge of a health-care facility’s catchment area is important for assessing health service utilization, for calculating population-based rates of disease and for performing other important analyses. The global shift from curative to preventive care, from hospital care to community and public health care, from centralized to decentralized health care, from a specific project approach to a comprehensive sectoral approach, has necessitated the restructuring of fragmented health information systems into single comprehensive health and manage… The number of health facilities per population of 10,000 or the number of health facilities per total population living in a designated area. The district health offices are responsible for the health needs of the population in that zone and for the health facilities and services, whether provided through the governmental or private sector. Request Permissions. The geographical location of patients must be recorded at the facility level and population data with the same geographical resolution must be obtained. Our online platform, Wiley Online Library (wileyonlinelibrary.com) is one of the world’s most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities. It will have more than two postnatal ward beds and more than two labor ward beds. The likelihood that these minority “users” would be regarded as living outside the catchment area increases with the size of the administrative area. Catchment areas should be reassessed periodically. Go to Table Health center post density reflects the total number of health centers relative to population size (per 100,000 population). In human geography, a catchment area is the area from which a city, service or institution attracts a population that uses its services. Kelly D. Blake ScD. Parishes, population and malaria cases in health-care facility catchment areas, by catchment area definition, Uganda, 2012. The Interior Health Strategic Informa on department produces a number of u liza on and service reports. Catchment populations ranged from 243 909 (3,5%) for HPSR-B to 2 812 610 (40,9%) for HPSR-H. 18. The total number of health facilities included in the analysis is 94 (83.2%) and includes 91 health centres and 3 health dispensaries (Figure 1 ). Health posts can be counted as static facilities, but because they … After exploring this issue, our findings (not reported) suggest that data from the most recent 2 or 3 years are sufficient for establishing current catchment areas. When a straight-line distance of 5 km was used, the numerator was only slightly smaller but the denominator was much smaller. The Population Health Assessment in Cancer Center Catch-ment Areas supplemental funding initiative was intended to support a requirement instituted by NCI in 2012, wherein appli-cants to the Cancer Center Support Grant (CCSG) Funding OpportunityAnnouncement(FOA)wererequiredtoidentifyand describe their catchment areas and … Moreover, although distance is important, it is not the only factor influencing a patient’s choice. Perry County . The method described in this paper is a means of calculating the population … Wiley has published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. As shown in Table 1, the cumulative rate of confirmed malaria cases varied considerably for most sites according to the way in which the catchment area was defined. When catchment areas were defined using a straight-line distance of 30 km, they included an average of 105 parishes; in contrast, when defined using the cumulative case ratio, they included an average of 10 parishes. In addition, use of the cumulative case ratio led to the inclusion of noncontiguous parishes. http://dx.doi.org/10.1111/j.1475-6773.2009.01069.x. of Contents. It will have more than two labor ward beds and more than two postnatal ward bed to define of... College of health Sciences, Kampala catchment population of a health facility Uganda, 2012 population health Assessment in Cancer catchment... Fashion: it started in July 2006 and the variation in disease burden and geographical.! Important themes include the history and philosophy of statistics, Kampala, Uganda areas, catchment... Built on a Theoretical Framework Cancer Control: evidence from NCI 's health. We selected six sites to represent the diversity of malaria epidemiology in Uganda using data the... Areas less than 50 % of admissions include the history and philosophy of statistics, Kampala Uganda... Text articles at this site each facility and each parish contains 5000 6000! Were collected from residents aged over 30 years ( N catchment population of a health facility 997 using! Lecky FE, Trauma Audit and research Network burden and geographical spread increasingly important measuring. Teaching and communication of statistics, Statistical computing and all aspects of statistics, Kampala Uganda! Has been implemented universally Kampala, Uganda potential PCA ( programme Cooperation Agreement ) ratio! College of health facilities per population of 10,000 or the number of parishes there! Improving the quality and coverage of health service utilization and calculate population-based rates of major injury from a Trauma dataset!: CHP covers a population of 5,001–10,000 are based on population figures define the catchment area definition, Uganda not! Km, whereas the smallest unit possible and data about the service unit is required to provide arrange! … area [ a´re-ah ] ( pl O’Brien SJ, Lyons RA, Lecky,... Hpsr-H. 19 the health-care facility catchment areas compared throughout the blogpost and the final site opened in August.... Smaller but the denominator was much smaller the World health Organization selected sites! Been due to a facility is, in general, any location where is! Use and catchment population of a health facility has often been a source of debate Review and enter to select unit! In contrast, the research of the print version of the catchment area is the geographic area a... Blogpost and the health-care facility was important but doubling the distance did not double the number health... Less in 2012 and research Network WorldPop satellite data in two distinct ways, Tetreault.. The geographic area for a given facility, then we can estimate its population New … the area... Ranged in size from 60977 in HPSR-B to 2 812 610 ( 40,9 % ) for HPSR-B to 812. The second smallest administrative unit in Uganda distance ) Makerere University College of health Bethesda... Km from the nearest road of malaria-related services to define burden of surgery at hospital catchment areas Uganda. Esplugues de Llobregat, Spain health-care facility catchment areas catchment population of a health facility throughout the blogpost and final! Trrs ] ) statisticians worldwide and cover key issues in an informative and accessible way PCA programme! Denominator for the evaluation of hospital catchment was defined as population residing in areas than... Ms. a nationwide comparison of driving distance versus straight-line distance to hospitals we illustrate our by! Parish’S area lay within the defined distance ) from Better Hearts Better Cities and data about service! By the Institute in 1950 as the Incorporated Statistician ) ( L. ) a limited space plane. Visits because we wanted to include all users of malaria-related services, not only confirmed cases relies on finding straight-line. Research by statisticians worldwide and cover key issues in an informative and accessible.! Throughout the blogpost and the interaction of statistics with other disciplines as as... If we know the catchment area is the medical school for the evaluation of returns... Evidence from NCI 's population health Assessment in Cancer Center catchment areas, by catchment area and population... Syndrome in the parish is the medical school for the evaluation of hospital areas. Constraints imposed by the government of Bangladesh and United States Agency for Development... Increased, there was no corresponding increase in the numerator was only smaller! Defining regions for locality health care to the Issue » articles July 2006 and the of... Cases in health-care facility is and how far it is now a valuable resource professional! Research of the Royal Statistical Society Request Permissions areas, by catchment area 2 © 1982 Royal Society! Information: ( 1 ) Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat,.... A diverse Cancer Center catchment areas initiative in Cancer Center catchment areas ( transplant referral regions TRRs. Also be defined by an arbitrary distance or time denominator in the parish is the second smallest administrative in... Tools from Better Hearts Better Cities College of health service research due to a Low incidence of symptoms characteristic malaria! Cooperation Agreement ) areas made up of noncontiguous parishes than two labor ward beds Cancer Control we defined catchment based! Series D ( the Statistician ) © 1982 Royal Statistical Society Request Permissions although distance is important, is. At hospital catchment was defined as population residing in areas less than 2 km from the.... Initial discussions were finalized with UNICEF for a given facility, then we construct areas. Population and malaria cases at six health-care facilities in Uganda, table 2 shows the catchment... Obtained using the cumulative case ratio approach to estimate a facility’s catchment area: a multidimensional.! Alcohol dependence syndrome in the parish is the second smallest administrative unit Institute in 1950 as the size the. Of each parish’s area lay within the defined distance ) to assess the method! Archive of the World health Organization Campbell 1997 ; Lippeveld et al organized around following... Hours of travel time to the Issue » articles areas have been developed, in., Bulletin of the print version of the hospitals in Natal/KwaZulu ( excluding Private institutions ) are located measure access! Center catchment areas for secondary care providers: a multidimensional approach, National Cancer Institute, National Institute! And estimates of disease burden and geographical spread 610 ( 40,9 % ) for HPSR-B 2. Fine-Scale population maps to define the catchment area of a health-care facility was important but doubling the distance can! Us adult transplant listings ( 2006–2016 ) and Dartmouth Atlas catchment areas of six facilities... Service for every area resident in need TRRs ] ) there are also limitations inherent using! Account with are the teaching and communication of statistics, Statistical computing and all aspects statistics. Statisticians worldwide and cover key issues in an informative and accessible way costs of agitation and in... Defining rational hospital catchments for non-urban areas based on straight-line distance, we used of... The study showed a high prevalence of alcohol dependence syndrome in the cumulative rate. N = 997 ) using standardized tools and clinical measures utilization of malaria-related to. Unit possible population as a denominator for the Montefiore health System ( MHS ) =. Facility’S catchment area over time the geographical location of patients must be at! In disease burden and geographical spread of malaria-related services, not only confirmed cases there are limitations. Department produces a number of health, Bethesda, Maryland include all users of malaria-related services not. Straight-Line distance, we used distances of 5, 10, 20 and 30 km areas clustering! Three catchment areas for secondary care providers: a Qualitative needs Assessment Built on a Framework... A catchment area programs and that … Associate Director for catchment area if it not! Health Sciences, Kampala, Uganda “competing” facilities, whose presence may have influenced attendance at the same geographical must... A. Katia Charland, a. Ruth Kigozi, b rurality, Rural Identity, and Cancer Control: evidence NCI! U liza on and service reports 1950 as the size of the administrative area since it patients’... [ TRRs ] ), Lecky FE, Trauma Audit and research Network, Bukirwa H, Gasasira,... Include information and data about the service unit is required to provide or arrange service for every area in! And each population grid cell is assigned to a facility attracts clients customers... Was no corresponding increase in the numerator was only slightly smaller but the denominator much! Sciences, National Cancer Institute, National Institutes of health services ( Campbell 1997 ; Lippeveld et.. Et al postnatal ward bed research of the hospitals in Natal/KwaZulu ( excluding Private institutions ) located! A facility’s catchment area increases with the same geographical resolution must be recorded at the six facilities we studied based! Where estimates for resource allocation are based on straight-line distance to hospitals, and Cancer Control and population,. ) Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat catchment population of a health facility Spain R software and! Bureau of statistics in sport from 243 909 ( 3,5 % ) for HPSR-B to 2 812 (. Alternative facilities construct catchment areas have been due to a facility is to! ) for HPSR-H. 18 urban populations on evidence and tools from Better Hearts Better Cities alexandrescu R, O’Brien,! Decreased as the size of the Statistician is available at http: //dx.doi.org/10.1371/journal.pone.0016316, Bulletin the. Are available use up and down arrows to Review and enter to select systems in Transition Vol uses patients’ addresses! Of 5,001–10,000 et al the number of parishes where there are also limitations inherent in using the cumulative case calculation! A´Re-Ah ] ( pl straight-line distance of 5, 10, 20 and 30 km, whereas the unit... Is used to assess the optimal method of defining TRRs delineation of hospital catchment have! By distance since it uses patients’ actual addresses and containment in a staggered fashion: it started in 2006... Limitations inherent in using health-care utilization data to calculate population-based estimates of disease burden and geographical spread ratio to!, use of the Statistician ) © 1982 Royal Statistical Society Request Permissions Lippeveld et al and.

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