Assessing Spatial Accessibility of Community Hospitals for the Elderly in Beijing, China

Jingya Luan, Yuhong Tian (), Chi Yung Jim, Xu Liu, Mengxuan Yan and Lizhu Wu
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Jingya Luan: State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Natural Resources, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
Yuhong Tian: State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Natural Resources, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
Chi Yung Jim: Department of Social Sciences, Education University of Hong Kong, Hong Kong, China
Xu Liu: China Academy of Urban Planning and Design (CAUPD), Beijing 100005, China
Mengxuan Yan: State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Natural Resources, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
Lizhu Wu: State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Natural Resources, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China

IJERPH, 2023, vol. 20, issue 1, 1-19

Abstract: Accessibility of health services signifies the quality and equitability of universal health provision. The hierarchical medical system recently implemented in China offers the policy instruments to improve medical services to the elderly in an aging society. As the critical primary care gateway, accessibility to community hospitals has significant impacts on people’s health. However, current research has paid little attention to spatial accessibility within walking distance of community hospitals, especially for the elderly. This study selected four districts with different urbanization levels in the rapidly developing Beijing metropolis. The spatial interaction model was applied to measure the accessibility of community hospitals for the elderly at the community level. An attractiveness index was computed based on key hospital traits. The results showed that: (1) community hospitals could cover 82.66% of elderly residents, and 77.63% of the communities were within walking distance. The served elderly proportion was relatively high in central urban areas and low in the suburbs. (2) The attractiveness indices of hospitals varied notably between districts, with higher values in more urbanized areas. (3) The spatial accessibility for the elderly of hospitals differed significantly between the four districts, with a descending gradient from central to suburban and rural areas, as indicated by the Gini coefficients and Lorenz curves. (4) The accessibility index was strongly related to the served elderly population and the hospital–residence distance. The findings provide policy directions to the government, including providing more primary-care resources to suburban and rural areas, building new community hospitals in identified provision gaps, upgrading some clinics to hospitals in rural areas, and planning hospitals according to the projected trend of the elderly population in terms of quantity and distribution. The considerable provision disparity between core urban, suburban and rural areas can be addressed by refined spatial health planning informed by research.

Keywords: spatial accessibility; aged population; spatial interaction model (SIM); community hospital; health equity; Beijing (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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