Original title: Minimum Attainment Cost: National Benchmark Framework for Measuring Healthcare Accessibility in Alzheimer’s Disease and Related Dementias-Related Services
Kyusik Kim, Amber DeJohn, Weining Kan · September 2026
Standard tools often measure healthcare access by drawing a fixed boundary around an area, like a thirty-minute drive. Because researchers choose these boundaries arbitrarily or keep them fixed, comparing urban and rural areas is hard. To fix this, researchers created the Minimum Attainment Cost framework. Instead of setting a rigid travel limit, this method calculates the shortest travel time a person needs to reach the national average share of a healthcare resource. It factors in how both people and facilities are spread across the country. In a nationwide United States analysis, the researchers compared this approach against fixed travel limits of 30, 60, 90, and 120 minutes. They found that rigid time limits either overestimate or underestimate healthcare access. In contrast, this new approach adjusts to different geographic settings, enabling fair comparisons across locations and providing better evidence for policy decisions.
Imagine deciding which grocery store to shop at based on how far you are willing to walk. Most people pick a fixed distance, say 10 minutes, and only consider stores within that radius. But if you live in a dense city, you might have many stores within 10 minutes, while in a rural area you might have none. Here, the fixed distance gives a misleading picture of grocery access. In this paper, instead of using a fixed travel time, the Minimum Attainment Cost finds the shortest time each neighborhood needs to reach the same level of grocery access as the national average, making comparisons fair.
Current methods use arbitrary travel time cutoffs to define which areas have access to Alzheimer's services. This can overestimate access in cities and underestimate it in rural areas, leading to misallocated resources. The new benchmark allows fair comparisons across different regions, helping policymakers target interventions where they are actually needed.
The abstract does not discuss limitations explicitly. However, the analysis is limited to Alzheimer's and related dementias services in the U.S., so applicability to other conditions or countries is not tested. The benchmark uses the national average facility-to-population ratio, which may not capture local variations in need or quality of services. The comparison is only against fixed thresholds (30,60,90,120 min), not against other context-sensitive measures.
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Minimum Attainment Cost: National Benchmark Framework for Measuring Healthcare Accessibility in Alzheimer’s Disease and Related Dementias-Related Services — Kyusik Kim, Amber DeJohn, Weining Kan — SocArXiv — doi:10.31235/osf.io/38geu_v1
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper. This is a preprint, so it hasn't necessarily been peer reviewed.