Spatial accessibility to hospitals in Southeast Iran: an enhanced two-step floating catchment area method

Access to hospitals in any healthcare system is a fundamental goal, but disparities in access can hinder this objective. Identifying areas with inadequate access to hospitals can help design plans to enhance access in these regions. This study aims to measure spatial access to hospitals in Sistan and Baluchestan Province in Southeast Iran using the enhanced two-step floating catchment area (E2SFCA) approach. The E2SFCA approach was applied to measure spatial accessibility to three types of total hospital beds (licensed, inpatient, temporary) and six types of specialized beds (emergency, ICU, CCU, internal medicine, surgical, and psychiatric) in Sistan and Baluchestan Province as our case study. The study revealed significant disparities in access to hospital beds, with nearly 30% (938,399 people) of the population lacking access to any hospital beds within a 30-min drive time. Additionally, 31% (972,100 people) of the population did not have access to emergency beds, 38% (1,203,986 people) to ICU beds, 38% (1,203,986 people) to CCU beds, 30% (938,399 people) to internal medicine beds, 36% (1,145,720 people) to surgical beds, and 65% (2,053,733 people) to psychiatric beds within the same drive time. The study highlights the unequal distribution of hospital beds in Sistan and Baluchestan Province, with significant variations between counties and different types of hospital beds. These findings have significant implications for policymakers and local health planners as they can use the accessibility scores to prioritize resource allocation, establish new hospitals, and improve access to healthcare services in underserved areas.