Measuring Accessibility to Healthcare Using Taxi Trajectories Data: A Case Study of Acute Myocardial Infarction Cases in Beijing

Document Type : Short Communication


1 School of Architecture, Tsinghua University, Beijing, China

2 School of Urban Design, Wuhan University, Wuhan, China

3 Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China

4 Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China

5 School of Architecture and Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing, China


Several methods have been applied to measure healthcare accessibility, ie, the Euclidean distance, the network distance, and the transport time based on speed limits. However, these methods generally produce less accurate estimates than actual measurements. This research proposed a method to estimate historical healthcare accessibility more accurately by using taxi Global Positioning System (GPS) traces. The proposed method’s advantages were evaluated vis a case study using acute myocardial infarction (AMI) cases in Beijing in 2008. Comparative analyses of the new measure and three conventionally used measures suggested that the median estimated transport time to the closest hospital with percutaneous coronary intervention (PCI) capability for AMI patients was 5.72 minutes by the taxi GPS trace-based measure, 2.42 minutes by the network distance-based measure, 2.28 minutes by the speed limit-based measure, 1.73 minutes by the Euclidean distance-based measure; and the estimated proportion of patients who lived within 5 minutes of a PCI-capable hospital was 38.17%, 89.20%, 92.52%, 95.05%, respectively. The three conventionally used measures underestimated the travel time cost and overestimated the percentage of patients with timely access to healthcare facilities. In addition, the new measure more accurately identifies the areas with low or high access to healthcare facilities. The taxi GPS trace-based accessibility measure provides a promising start for more accurately estimating accessibility to healthcare facilities, increasing the use of medical records in studying the effects of historical healthcare accessibility on health outcomes, and evaluating how accessibility to healthcare changes over time.


  1. Nallamothu BK, Bates ER, Wang Y, Bradley EH, Krumholz HM. Driving times and distances to hospitals with percutaneous coronary intervention in the United States: implications for prehospital triage of patients with ST-elevation myocardial infarction. Circulation. 2006;113(9):1189-1195. doi:1161/circulationaha.105.596346
  2. Dejardin O, Jones AP, Rachet B, et al. The influence of geographical access to health care and material deprivation on colorectal cancer survival: evidence from France and England. Health Place. 2014;30:36-44. doi:1016/j.healthplace.2014.08.002
  3. Berlin C, Panczak R, Hasler R, Zwahlen M. Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study. BMJ Open. 2016;6(11):e013090. doi:1136/bmjopen-2016-013090
  4. Cubbin C, Winkleby MA. Protective and harmful effects of neighborhood-level deprivation on individual-level health knowledge, behavior changes, and risk of coronary heart disease. Am J Epidemiol. 2005;162(6):559-568. doi:1093/aje/kwi250
  5. Ersbøll AK, Kjærulff TM, Bihrmann K, Schipperijn J, Gislason G, Larsen ML. Geographical variation in a fatal outcome of acute myocardial infarction and association with contact to a general practitioner. Spat Spatiotemporal Epidemiol. 2016;19:60-69. doi:1016/j.sste.2016.06.001
  6. Kjærulff TM, Ersbøll AK, Gislason G, Schipperijn J. Geographical clustering of incident acute myocardial infarction in Denmark: a spatial analysis approach. Spat Spatiotemporal Epidemiol. 2016;19:46-59. doi:1016/j.sste.2016.05.001
  7. Madsen M, Davidsen M, Rasmussen S, Abildstrom SZ, Osler M. The validity of the diagnosis of acute myocardial infarction in routine statistics: a comparison of mortality and hospital discharge data with the Danish MONICA registry. J Clin Epidemiol. 2003;56(2):124-130. doi:1016/s0895-4356(02)00591-7
  8. Viik-Kajander M, Moltchanova E, Salomaa V, et al. Geographical variation in the incidence of acute myocardial infarction in eastern Finland--a Bayesian perspective. Ann Med. 2003;35(1):43-50. doi:1080/07853890310004129
  9. Finch E, Liu Y, Foster M, et al. Measuring access to primary healthcare services after stroke: a spatial analytic approach. Brain Impair. 2019;20(3):240-250. doi:1017/BrImp.2019.11
  10. Tian Q, Ren F, Hu T, Liu J, Li R, Du Q. Using an optimized Chinese address matching method to develop a geocoding service: a case study of Shenzhen, China. ISPRS Int J Geoinf. 2016;5(5):65. doi:3390/ijgi5050065
  11. Wang F, Xu Y. Estimating O–D travel time matrix by Google Maps API: implementation, advantages, and implications. Ann GIS. 2011;17(4):199-209. doi:1080/19475683.2011.625977
  12. Yamashita T, Kunkel SR. The association between heart disease mortality and geographic access to hospitals: county level comparisons in Ohio, USA. Soc Sci Med. 2010;70(8):1211-1218. doi:1016/j.socscimed.2009.12.028
  13. Owen KK, Obregón EJ, Jacobsen KH. A geographic analysis of access to health services in rural Guatemala. Int Health. 2010;2(2):143-149. doi:1016/j.inhe.2010.03.002
  14. Bamford EJ, Dunne L, Taylor DS, Symon BG, Hugo GJ, Wilkinson D. Accessibility to general practitioners in rural South Australia. A case study using geographic information system technology. Med J Aust. 1999;171(11-12):614-616.
  15. Fleming LC, Ansumana R, Bockarie AS, et al. Health-care availability, preference, and distance for women in urban Bo, Sierra Leone. Int J Public Health. 2016;61(9):1079-1088. doi:1007/s00038-016-0815-y
  16. Paez A, Mercado RG, Farber S, Morency C, Roorda M. Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents. Int J Health Geogr. 2010;9:52. doi:1186/1476-072x-9-52
  17. Schuurman N, Fiedler RS, Grzybowski SC, Grund D. Defining rational hospital catchments for non-urban areas based on travel-time. Int J Health Geogr. 2006;5:43. doi:1186/1476-072x-5-43
  18. Wang F, McLafferty S, Escamilla V, Luo L. Late-stage breast cancer diagnosis and health care access in Illinois. Prof Geogr. 2008;60(1):54-69. doi:1080/00330120701724087
  19. Bates DW, Ebell M, Gotlieb E, Zapp J, Mullins HC. A proposal for electronic medical records in U.S. primary care. J Am Med Inform Assoc. 2003;10(1):1-10. doi:1197/jamia.m1097
  20. Deng B, Denman S, Zachariadis V, Jin Y. Estimating traffic delays and network speeds from low-frequency GPS taxis traces for urban transport modelling. Eur J Transp Infrastruct Res. 2015;15(4):639-661. doi:18757/ejtir.2015.15.4.3102
  21. Xie W, Li G, Zhao D, et al. Relationship between fine particulate air pollution and ischaemic heart disease morbidity and mortality. Heart. 2015;101(4):257-263. doi:1136/heartjnl-2014-306165
  22. Ministry of Housing and Urban-Rural Development of People’s Republic of China. Code for Design of Urban Road Engineering. Beijing: China Architecture & Building Press; 1999.
  23. Boersma E, Maas AC, Deckers JW, Simoons ML. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet. 1996;348(9030):771-775. doi:1016/s0140-6736(96)02514-7
  24. Boscoe FP, Henry KA, Zdeb MS. A nationwide comparison of driving distance versus straight-line distance to hospitals. Prof Geogr. 2012;64(2):188-196. doi:1080/00330124.2011.583586
  25. Geldsetzer P, Reinmuth M, Ouma PO, et al. Mapping physical access to healthcare for older adults in sub-Saharan Africa: a cross-sectional analysis with implications for the COVID-19 response. medRxiv [Preprint]. August 26, 2020. Available from:
  26. Sui Y, Yang J, Xu H, et al. Emergency medical services use in patients with ST elevation myocardial infarction in China: findings from China Acute Myocardial Infarction (CAMI) registry. Chin Circ J. 2019;34(2):128-133.
  27. Roy N, Murlidhar V, Chowdhury R, et al. Where there are no emergency medical services-prehospital care for the injured in Mumbai, India. Prehosp Disaster Med. 2010;25(2):145-151. doi:1017/s1049023x00007883
  • Receive Date: 20 August 2021
  • Revise Date: 24 July 2022
  • Accept Date: 06 September 2022
  • First Publish Date: 07 September 2022