[HN Gopher] Mapping hospital accessibility with OpenStreetMap
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Mapping hospital accessibility with OpenStreetMap
Author : wcedmisten
Score : 141 points
Date : 2023-04-04 03:00 UTC (1 days ago)
(HTM) web link (wcedmisten.fyi)
(TXT) w3m dump (wcedmisten.fyi)
| sl-dolt wrote:
| That's really cool. I'll probably end up trying to reproduce this
| by following your work step-by-step. I'm not too familiar with
| OSM, besides having used Nominatim.
|
| Along the same lines we're crowdsourcing a database of hospital
| prices, starting this week. I'm reviewing our first pull request
| as we speak. You can follow our progress live. The data is here:
| https://www.dolthub.com/repositories/dolthub/standard-charge...
|
| We talked a little about the problems we're encountering here:
| https://docs.google.com/document/d/1uMx1sUYwP_uE7ebd3PtGvF0t...
| and here
| https://docs.google.com/document/d/1NifwgKHBCeF35ZRZsfpgg4bE...
| wcedmisten wrote:
| Thanks! You're doing awesome work, I read the blog post about
| the insurance data mess you're working through.
|
| I'll see if I can incorporate that into my project!
|
| I'd love to see what this map looks like filtered for specific
| services.
| sl-dolt wrote:
| > I'd love to see what this map looks like filtered for
| specific services.
|
| Sure. I did something like that with our insurance data. Did
| a quick folium visualization. You can start from here:
|
| https://www.dolthub.com/repositories/dolthub/hospital-
| prices...
|
| A limitation of our dataset is it excludes percentage-based
| contracts. So those won't show up.
|
| Anyways, if you have the hospital NPI you want, you can look
| up all of its dollar-amount negotiated rates in this table.
| You can link that to the `hospital` table, geocode however
| you want, and make a map of the different rates. Note,
| however, that the insurance data published here is kind of a
| mess and, I think, contains many many mistakes (originating
| in the source data.)
|
| BTW, I'm not sure if this insurance-derived hospital data
| exists anywhere else. I believe it doesn't.
| twic wrote:
| > [The Global Human Settlement Layer (GHS) Population dataset 6.]
| is formatted as an image of 100m x 100m squares, each containing
| the estimated population residing in each square. [...] due to
| the unconventional projection used (Mollweide 7), the image
| appears slanted and skewed compared to a more traditional
| projection.
|
| How do you divide a Mollweide projection into 100m x 100m
| squares? In fact, how do you divide any projected globe into 100m
| x 100m squares?! Do they actually mean 10,000 m2 squares? Because
| you could do that, they would just get narrower and longer
| towards the poles.
| wcedmisten wrote:
| Apologies for the confusion!
|
| I meant that the data is represented as an image (of square
| pixels). But you're right, the actual land that each pixel
| represents won't be a square.
|
| The dataset just says "100m resolution", so that may have been
| a misinterpretation on my part.
|
| https://ghsl.jrc.ec.europa.eu/download.php?ds=pop
| fsflyer wrote:
| See https://github.com/emigre459/hospital-chargemaster for an
| older study of hospitals. It gets the chargemaster prices that
| hospitals are supposed to publish. The procedures offered could
| be mapped to your "services".
| wcedmisten wrote:
| Awesome, thanks! I'll look into that
| e4e5 wrote:
| Awesome work, love stuff like this!
|
| Also amazing to see how much open source software already exists
| for GIS, lowering the entry requirements to almost zero.
| wcedmisten wrote:
| Thank you!
|
| Being able to create interactive map visualizations without
| needing a server or paying for an API key is a real game
| changer!
|
| Big shoutout to the Protomaps project and all the other open
| source projects in the ecosystem.
| chrisshroba wrote:
| This is an amazing write-up and I'm super excited to play around
| with a lot of the open source projects you referenced. Thanks so
| much for sharing.
| nerdponx wrote:
| Great analysis, thank you for sharing.
|
| A (maybe obvious) corollary is that you can use this data to
| easily evaluate the effect of a hospital closure (or other change
| in services/access) in terms of number of people affected.
| mistrial9 wrote:
| keyword search "medically underserved"
|
| Similar to the recent news item "why does nobody live in 90% of
| New Zealand" .. in the wealthy and wonderful US of A, there are
| vast areas where there are no general practitioner doctors on
| call, and some areas where there are no hospitals at all.
|
| As mentioned in other comments, the road network is less than
| half of the accessibility story, the rest is about money.
| kwhitefoot wrote:
| > in the wealthy and wonderful US of A, there are vast areas
| where there are no general practitioner doctors on call,
|
| If by that you mean doctors who make home visits then I have
| news for you: there are entire western countries where doctors
| do not make house calls. In Norway you are expected to to make
| an appointment to visit your GP, or make your own way to an
| outpatient clinic (legevakt) or the accident and emergency
| department at a hospital. If you can't do any of that you are
| expected to call an ambulance.
|
| I haven't heard of GPs making home visits in the UK either in
| recent and not so recent decades.
| mistrial9 wrote:
| great greetings to Norway ! .. no, I don't mean "house call"
| .. that disappeared here more than fifty years ago. I mean
| that in an entire area, there is not one single doctor in any
| way.
| edent wrote:
| Fascinating - and well written.
|
| Regarding the problem of roads "leaking" into neighbouring
| states... is that an issue? If your nearest hospital was either
| 60 minutes away in-state or 10 minutes away across state lines -
| which would people generally choose?
| wcedmisten wrote:
| Thank you!
|
| The roads leaking is only an issue for determining the
| percentage of state residents within an area, because the
| regions also include out of state residents.
|
| But what you describe is another limitation of my approach.
| Currently, only Virginia hospitals are considered in this, so
| some regions will actually have better hospital accessibility
| than presented here, particularly near state borders.
|
| Now that I've polished this setup for one state, my plan is to
| expand the project to the US (or maybe all of North America),
| which should fix the issue you describe.
| yumbrand wrote:
| Interesting -- I have reservations on the breadth of OSM, but
| maybe that's different for hospital locations. I've looked into
| how representative it is for some large public companies like
| Target and Walmart, but I've found that consistently, less than
| half of all stores are actually represented; plus, with the
| addition of smaller out-patient locations like urgent care
| centers, I'm not sure how truthful this picture really is.
| toomuchtodo wrote:
| I think where OSM really shines is when you plug in other data
| sources that have large institutional support keeping them
| accurate and timely. You're then providing mapping data off of
| that data, "drafting" off of it if you will.
|
| For example, if you want to keep hospital state up to date,
| ingest public payment data from Medicare/Medicaid and distill
| down by location. When fiat is at stake, there is more at stake
| wrt data accuracy.
|
| Edit: fsflyer points this out in a below comment, mea culpa
|
| https://news.ycombinator.com/item?id=35434775
| autokad wrote:
| hospitals can be challenging. lots get shut down, and the
| smaller ones have severely misplaced coordinates because these
| surveys go out to the hospitals and a clerk will fill them out
| with an address, and that address gets geocoded. The address
| they give is sometimes an address to a branch hospital, or a
| different building than the treatment center of interest. Very
| large hospitals have an issue in this way too, and since they
| are so big that difference can effect the map and access a lot.
| wcedmisten wrote:
| Yeah, I think using another data source for hospitals would be
| better, I'll look into using supplemental data as the other
| comment suggested.
|
| I suspect that hospitals are better represented than other POIs
| because their building footprints are large and distinctive,
| allowing them to be mapped from aerial imagery.
|
| I limited this analysis to facilities providing inpatient care
| to avoid that problem. I suspect clinics are less accurate
| POIs. They're pretty much indistinguishable from other retail
| businesses from aerial imagery alone.
| samstave wrote:
| This is awesome.
|
| As someone who has designed and commissioned quite a few
| hospitals over the years, this data is really interesting to me,
| especially as I have been on the front of how much hospital
| projects cost - from vendors selling "hospital grade" electronics
| (snake oil), to managing design build of full facilities from
| greenfield to clinical operations go live... Hospitals are
| ridiculously expensive "just because thats how it is"
|
| Another interesting data point to add to this would be the
| mapping of reported income by city/county... I did this for
| Cannabis Dispensaries a few years ago - where I mapped out all
| the licenses granted by the BCC (now DCC) to dispensaries, and
| the average income level of the population surrounding each
| dispensary...
|
| Then, I looked at reports to the BCC for reported income, where
| the average dispensary (at the time) was making $2MM/y -- its got
| to be much higher now....
|
| It would be interesting to see the average income for the various
| populations in each time-strata as well.
| fabk wrote:
| Nice to see the localhost solution! I (my team) did very similar
| when I was a postdoc. In 2015 we used the HERE API (www.here.com)
| to map geographical access to hospitals in the entirety of two
| countries, USA and Brazil.
|
| As starting point, I used the lat/lon of the population center of
| each census block group as provided by Census.gov. In Brazil the
| closest geographical equivalent is the setor censitario (census
| sector). I used Haversine distance (great circle distance between
| lat/lon's) to narrow the search space to the 5 closest hospitals,
| from the hospital database by the American Hospital Association,
| and the Brazilian CNES registry (Cadastro Nacional de
| Estabelecimentos de Saude). From those 5 closest candidates, I
| then asked the HERE API for the true driving time to their
| address. Many many API calls.
|
| We plotted average driving time against variables from the census
| block group provided by the American Community Survey to show how
| values change as driving distances change. Mostly just to
| demonstrate the kind of analyses possible. I presented the work
| at the NLM Informatics Training confereces, e.g. with many
| pictures of maps:
| https://github.com/fabkury/drithop/raw/master/Kury%20-%20dri... .
| Source code (but not data) are in the GitHub repo `drithop`. The
| maps are self-contained HTML files and interactive using
| OpenStreetMap.
| slazien wrote:
| Related: me and my colleagues at Georgia Tech created something
| similar for multiple types of Points of Interest and developed
| and accessibility index. Our methodology was a bit different
| though: https://arxiv.org/abs/2212.06954
| autokad wrote:
| I built a similar website when working for a research lab ~2009.
| The lab is now closed, and thus so is the website but you can see
| some screen shots in this old time article:
| https://content.time.com/time/health/article/0,8599,2083636,...
|
| What was interesting how many jurisdictions got mad at me,
| because they thought I was targeting them. A hospital in Chicago
| that shut down their trauma center to save money but caused the
| south side of Chicago to loose 1 hour access thought I was
| targeting them as revenge over that action. The Florida Keys was
| mad at me because they had a hospital but no access and I'd be
| like "I'm sorry but that hospital is not a Trauma center and this
| is a Trauma Center access map, if the hospital gets certified I'd
| be happy to update the data".
|
| The hardest part was the data. I had to join the list of Trauma
| centers (levels 1 - 5, about 500 hospitals) with a hospital
| database (~5500 hospitals) to get additional information. I had
| to verify manually all the joins as well as the GPS coordinates.
|
| Its a shame the app got shut down, it had some useful tools. You
| could see trauma center access via ambulance, air ambulance, or
| both for 45 and 60 minutes. It also had overlays for hospitals,
| trauma centers (levels 1, 2,..5), stroke centers, VA hospitals,
| and helipads. I also built an additional tool in a similar app to
| 'build your own hospital system' by clicking on available
| hospitals and 'upgrading' them to a TC or stroke center and then
| see how many people in the state gained access.
| ljegou wrote:
| The Malaria Atlas Project worked on a global hospital
| accessibility dataset, base on OSM roads + other data :
|
| Travel Time to Nearest Healthcare Facility with Access to
| Motorized Transport
| https://data.malariaatlas.org/maps?layers=Malaria:202206_Glo...
|
| Paper :
| https://researchonline.lshtm.ac.uk/id/eprint/4657237/1/weiss...
| poulsbohemian wrote:
| I applaud the effort, but the challenges of rural health are even
| greater than just proximity to a hospital. For example, in my
| area we have multiple hospitals and clinics, but... have heart
| issues? Hour drive. Need cancer care? Likely driving between 3-5
| hours toward one of the bigger metro areas. There is exactly one
| (!!) urologist in town. Need some kind of basic surgery (gall
| bladder, for example) guess what - there are a couple guys that
| rotate here every few weeks from one of the major cities (where
| they actually live). That's before we get into the clusterF that
| is the American insurance system.
|
| Our rural hospitals are basically triage care and basic
| immunizations / antibiotics.
| TulliusCicero wrote:
| Isn't that a straightforwardly expected result of low
| population density?
|
| If your area doesn't have many people, that means less demand
| for certain things, potentially not enough demand to keep
| permanent staff for particular types of care.
|
| Of course, the other issue is that doctors (and nurses?) may
| simply not want to live in rural areas, even with the financial
| advantages.
| poulsbohemian wrote:
| I don't really disagree, but for what it's worth within an
| hour radius of my location there are roughly 400,000
| people... so how dense do things have to be before it's
| enough to support specialty care?
| TulliusCicero wrote:
| Hmm, that does seem like it should be enough to support
| things like heart care or general surgery, there _should_
| be enough demand. I imagine people who actually work in the
| industry might have some insights on why this would happen.
| zootboy wrote:
| I'm curious how confident you are that all hospitals in the state
| are listed in the OSM database. In my experience, the point of
| interest data in OSM is highly variable, with many being totally
| absent. I know you mentioned a few mis-tagged hospitals, but did
| you look for missing ones?
| wcedmisten wrote:
| I don't have a great data source for hospitals to cross
| reference, but I suspect hospitals are better represented than
| other POIs in OSM. Hospitals generally have very large and
| distinctive building footprints, which means "armchair mappers"
| using aerial imagery can still map them.
|
| If I was looking at clinics, I believe this would be a bigger
| problem, because they're indistinguishable from other retail
| businesses in the aerial imagery.
| taveras wrote:
| This is super cool!
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