Spatiotemporal relationships between spatial accessibility to intensive care unit beds and mortality of COVID-19 in the state of Texas

Author(s): Jinwoo Park, Alexander Michels, Fangzheng Lyu, Su Yeon Han, Shaowen Wang

During the coronavirus disease 2019 (COVID-19) pandemic, many patients could not receive timely healthcare services due to limited access to hospital infrastructure and human resources. Previous research showed that sufficient access to healthcare resources, such as intensive care unit (ICU) beds and ventilators, is important to save lives. However, little attention has been paid to the underlying temporal dynamics of healthcare resource availability and COVID-19 cases. To fill this gap, our study aims to investigate the spatiotemporal relationships between spatial accessibility to ICU beds and the mortality of COVID-19, under the changes in ICU bed availability and COVID-19 confirmed cases. We first integrate the historical temporal changes of availability and confirmed cases to assess daily spatial accessibility to ICU beds with an enhanced two-step floating catchment area (E2SFCA) method. We then observe how insufficient accessibility to ICU beds and increased mortality are correlated with Kendall’s tau. As results, strong negative correlation coefficients were observed in the county-level analysis between sufficient accessibility to ICU beds and mortality of COVID-19. In addition, we found that populous counties in North, Southeast, and Central Texas showed a more substantial relationship than those in West Texas, which have sparse population density. Our study identified vulnerable areas where low spatial accessibility levels were highly related to deaths based on their retrospective relationship. We also suggested that extra resources might be necessary for big cities to adequately deal with the acute surge of patients, which could support policymakers in saving lives for future pandemic scenarios.


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