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

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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
    Guangdong Key Laboratory of Urban Informatics, Shenzhen University, Shenzhen 518060, China
    MNR Technology Innovation Centre of Territorial & Spatial Big Data, 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)

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.

Suggested Citation

  • Meng Tian & Lei Yuan & Renzhong Guo & Yongsheng Wu & Xiaojian Liu, 2022. "Evaluations of Spatial Accessibility and Equity of Multi-Tiered Medical System: A Case Study of Shenzhen, China," IJERPH, MDPI, vol. 19(5), pages 1-18, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:3017-:d:764345
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    References listed on IDEAS

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    1. Pan, Jay & Zhao, Hanqing & Wang, Xiuli & Shi, Xun, 2016. "Assessing spatial access to public and private hospitals in Sichuan, China: The influence of the private sector on the healthcare geography in China," Social Science & Medicine, Elsevier, vol. 170(C), pages 35-45.
    2. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    3. Jan Bauer & David A Groneberg, 2016. "Measuring Spatial Accessibility of Health Care Providers – Introduction of a Variable Distance Decay Function within the Floating Catchment Area (FCA) Method," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-17, July.
    4. Chen, Qiulin & Xu, Duo & Fu, Hongqiao & Yip, Winnie, 2022. "Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China," China Economic Review, Elsevier, vol. 72(C).
    5. Jiang, Shan & Gu, Yuanyuan & Yang, Fan & Wu, Tao & Wang, Hui & Cutler, Henry & Zhang, Lufa, 2020. "Tertiary hospitals or community clinics? An enquiry into the factors affecting patients' choice for healthcare facilities in urban China," China Economic Review, Elsevier, vol. 63(C).
    6. Sinha, Antika & Chakrabarti, Bikas K., 2019. "Inequality in death from social conflicts: A Gini & Kolkata indices-based study," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 527(C).
    7. Dahlgren, Cecilia & Dackehag, Margareta & Wändell, Per & Rehnberg, Clas, 2021. "Simply the best? The impact of quality on choice of primary healthcare provider in Sweden," Health Policy, Elsevier, vol. 125(11), pages 1448-1454.
    8. Bowles, Samuel & Carlin, Wendy, 2020. "Inequality as experienced difference: A reformulation of the Gini coefficient," Economics Letters, Elsevier, vol. 186(C).
    9. Jomehpour Chahar Aman, Javad & Smith-Colin, Janille, 2020. "Transit Deserts: Equity analysis of public transit accessibility," Journal of Transport Geography, Elsevier, vol. 89(C).
    10. Gonçalo Santinha & Jan Wolf & Catarina Costa, 2020. "Aging and the built environment: is mobility constrained for institutionalized older adults?," Journal of Urbanism: International Research on Placemaking and Urban Sustainability, Taylor & Francis Journals, vol. 13(4), pages 431-447, October.
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    1. Yibin Ao & Qiqi Feng & Zhongli Zhou & Yunfeng Chen & Tong Wang, 2022. "Resource Allocation Equity in the China’s Rural Three-Tier Healthcare System," IJERPH, MDPI, vol. 19(11), pages 1-17, May.

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