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Access is defined as the equal opportunity of people to get appropriate care to maintain or improve their health. Addressing disparities in healthcare access has been on the national policy agenda since the 1967 Report of the National Advisory Commission on Health Manpower. Several policy interventions to improve access have been studied, implemented and evaluated, including various provisions contained in the Patient Protection and Affordable Care Act (ACA). Much of the success of the ACA will depend on issues related to access to care, and its impact will be highly variable among states and extended over time.
What We Do
The Five Dimension Framework
Existing research has focused on five dimensions of access: affordability, accessibility, availability, accommodation and acceptability. In our research, we primarily focus on accessibility and availability as the objectives of the system’s optimality whereas other dimensions specify constraints of the care system. One important constraint of the acceptability dimension is the participation of healthcare providers in the Medicaid program.
Within this framework, we focus on Measurement, Inference, Interventions and Linking to Outcomes.
Evaluating spatial access of different populations by taking into account supply and demand trade-offs and system constraints using optimization models.
Studying systematic disparities in access between population groups defined by geographic location and demographic characteristics using spatial statistics.
Designing targeted interventions and estimating impact on system through optimization models.
Link to outcomes
Linking access to outcomes (statistically) and optimizing interventions likely to positively affect health outcomes or inequities.
Georgia Tech Contributors
Gentili, M., Serban, N., Harati, P., O'Connor, J., Swann, J. (2018) Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care with Implications for Policy, Health Services Research, 53(3), 1458-1477.
Johnson, B., Ngueyep, R., Schechter, M., Serban, N., Swann, J. (2018) A study of the Impact of Geographic Access on Health Outcomes for Cystic Fibrosis, Peadiatric Pulmonology, 53(3), 284-292.
Serban, N., Tomar, S. (Accepted June 2018) ADA Health Policy Institute’s Methodology Overestimates Spatial Access to Dental Care for Publicly Insured Children, Journal of Public Health Dentistry, in press.
Serban, N., Bush, C., Tomar, S. (Submitted August 2018) Medicaid Capacity for Pediatric Dental Care. Journal of the American Dental Association, under 1st review.
Cao, S., Gentili, M., Griffin, P., Griffin, S., Serban, N. (2017). Disparities in Access to Preventive Dental Care between Publicly and Privately Insured Children in Georgia. Preventive Disease Control, 14:170176.
Cao, S., Gentili, M., Griffin, P., Griffin, S., Harati, P., Johnson, B., Serban, N., Tomar, S. (2017) Estimating demand for and supply of pediatric preventive dental care for children and identifying dental care shortage areas, Georgia, Public Health Reports, 132(3) 343-349.
Heier Stamm, N. Serban, J. Swann, and P. Wortley (2017), “Quantifying and Explaining Accessibility of H1N1 Vaccine during the 2009 pandemic”, Health Care Management Science, 20(1), 76-93.
Harati, P., Gentili, M., Serban, N. (2016) Projecting the Impact of the Affordable Care Act Provisions on Accessibility and Availability of Primary Care for the Adult Population in Georgia, Journal of the American Public Health, 106(8):1470-6..
Li, Z., Serban, N., Swann, J.(2015),”An optimization framework for measuring spatial access over healthcare networks", BMC Health Services Research, 15:273.
Garcia, E., N. Serban , J. Swann, and A. Fitzpatrick (2015). “A Study of the Impact of Geographic Access on Severe Health Outcomes for Pediatric Asthma”, Journal of Allergy and Clinical Immunology, featured as New Research Article, 136(3):610-8.
Yan, R., Bastian, N.D., and Griffin, P.M. (2015), “Association of Food Environment and Food Retailers with Obesity in US Adults”, Health and Place, 33, 19-24.
Gentili, M., Isett, K., Serban, N., Swann, J. (2015) Small-Area Estimation of Spatial Access to Pediatric Primary Care and Its Implications for Policy. Journal of Urban Health, 92(5):864-909.
M. Nobles, N. Serban, J. Swann (2014), Spatial Accessibility of Pediatric Primary Healthcare: Measurement and Inference, Annals of Applied Statistics, 8 (4), 1922-1946.
Griffin, P.M., Lee, H., Scherrer, C., Swann, J.L. (2014), “Balancing Investments in Federally Qualified Health Centers and Medicaid for Improved Access and Coverage in Pennsylvania”, Health Care Management Science, Vol. 17, pp. 1-17.
Griffin, P., C. Scherrer, and J. Swann (2008). “Optimal Location of Community Health Centers using Synthetic Estimates for Need.” IIE Transactions (Special Issue on Healthcare Engineering) 40(9):880-892.
W. B. Rouse & N. Serban (2014). Understanding and Managing the Complexity of Healthcare. MIT Press
Centers for Disease Control and Prevention, Atlanta, GA, "Health Analytics at Georgia Tech: From Information to Knowledge to Decision Making", N. Serban, J. Swann, May, 2014. Download
IIE Annual Conference, Montreal, Canada, "Quantifying and Explaining Access to H1N1 Vaccine", Heier Stamm, J., Serban, N., Swann, J., June, 2014. Download
Emory University, Rollins School of Public Health, Research Advisory Committee Meeting, Atlanta, GA, "Engineering in Public Health for Efficient, Effective, and Equitable Outcomes", N. Serban, J. Swann, November, 2013. Download
Wang, F.H. (2012). “Measurement, Optimization, and Impact of Health Care Accessibility: A Methodological Review.” Annals of the Association of American Geographers. 102(5): p. 1104-1112.
Daskin, M.S., L.K. Dean (2004) Location of Health Care Facilities, in Handbook of OR/MS in Health Care: A Handbook of Methods and Applications, M.B. F. Sainfort, W. Pierskalla, Editor. p. 43-76.
Talen, E., & Anselin, L. (1998). “Assessing spatial equity: an evaluation of measures of accessibility to public playgrounds.” Environment and Planning A, 33, 595-613.
Penchansky, R., & Thmoas, J. W. (1981). “The Concept of Access: Definition and Relationship to Consumer Satisfaction.” Medical Care, 19(2), 127-140.