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Evaluations of Spatial Accessibility and Equity of Multi-Tiered Medical System: A Case Study of Shenzhen, China

Meng Tian, Lei Yuan, Renzhong Guo, Yongsheng Wu and Xiaojian Liu
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Meng Tian: Lab for Optimizing Design of Built Environment, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
Lei Yuan: Lab for Optimizing Design of Built Environment, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
Renzhong Guo: Research Institute for Smart Cities, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
Yongsheng Wu: Shenzhen Centre for Disease Control and Prevention, Shenzhen 518055, China
Xiaojian Liu: Shenzhen Centre for Disease Control and Prevention, Shenzhen 518055, China

IJERPH, 2022, vol. 19, issue 5, 1-18

Abstract: The Chinese government has implemented a medical system reform to improve the equity of healthcare resources since 2009. We selected Shenzhen as our study area and evaluated the accessibility and equity of the multi-tiered medical system in China using a novel multi-tiered two-step floating catchment area (MT2SFCA) method. We proposed the benchmark and applied the independent variables of travel time and facility attractiveness, along with a combination of the two factors, as tolerances to determine the new logistic cumulative distribution decay functions. Community health centers (CHCs) and hospitals were included while integrating their features. Results revealed that the MT2SFCA method was able to determine the particular advantages of CHCs and hospitals in the multi-tiered medical system. The CHCs offset the lower accessibility of hospitals in suburban areas and hospitals balanced the regional inequity caused by the CHC. Travel time is the main consideration of patients who have access to CHCs, whereas facility features are the main considerations of patients who have access to hospitals. Notably, both CHCs and hospitals are crucial for the whole multi-tiered medical system. Finally, we suggested modifications in different travel modes, weights of contributing factors, and the validation of decay functions to improve the MT2SFCA method.

Keywords: spatial accessibility; medical system; multi-tiered two-step floating catchment area (MT2SFCA) method; equity; healthcare (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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