IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v209y2018icp14-24.html
   My bibliography  Save this article

Spatial accessibility of primary health care in China: A case study in Sichuan Province

Author

Listed:
  • Wang, Xiuli
  • Yang, Huazhen
  • Duan, Zhanqi
  • Pan, Jay

Abstract

Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China. The Nearest-Neighbor method, Enhanced Two-Step Floating Catchment Area (E2SFCA) method, and Gini Coefficient are utilized to represent travel impedance, spatial accessibility, and disparity of primary health care resources (hospital beds, doctors, and health professionals). Accessibilities and Gini Coefficients are correlated with social development indexes (GDP, ethnicity, etc.) to identify influencing factors. Spatial access to primary health care is better in southeastern Sichuan compared to northwestern Sichuan in terms of shorter travel time, higher spatial accessibility, and lower inequity. Social development indexes all showed significant correlation with county averaged spatial accessibilities/Gini Coefficients, with population density ranking top. The disparity of access to primary health care is also apparent between ethnic minority and non-minority regions. To improve spatial access to primary health care and narrow the inequity, more township health centers staffed by qualified health professionals are recommended for northwestern Sichuan. Improved road networks will also help. Among areas with insufficient primary health care, the specific counties where demographics are dominated by older people and children due to widespread rural-urban migration of the workforce, and by ethnic minorities, should be especially emphasized in future planning.

Suggested Citation

  • Wang, Xiuli & Yang, Huazhen & Duan, Zhanqi & Pan, Jay, 2018. "Spatial accessibility of primary health care in China: A case study in Sichuan Province," Social Science & Medicine, Elsevier, vol. 209(C), pages 14-24.
    • Handle: RePEc:eee:socmed:v:209:y:2018:i:c:p:14-24
    DOI: 10.1016/j.socscimed.2018.05.023
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953618302582
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2018.05.023?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yang Yu & Yijin Wu & Xin Xu & Yun Chen & Xiaobo Tian & Li Wang & Siyun Chen, 2021. "Spatial Disparities and Correlated Variables of Community Care Facility Accessibility in Rural Areas of China," Sustainability, MDPI, vol. 13(23), pages 1-14, December.
    2. Voicu, Bogdan & Fărcășanu, Dana & Mustață, Mirela & Deliu, Alexandra & Vișinescu, Iulia, 2023. "Using laws, common sense, and statistical approaches to design indicators for ‘medical desertification’. An application on the Romanian case," Social Science & Medicine, Elsevier, vol. 327(C).
    3. Ting Chen & Jay Pan, 2022. "The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 645-665, April.
    4. Shen, Chi & Lai, Sha & Deng, Qiwei & Cao, Dan & Zhao, Dantong & Zhao, Yaxin & Zhou, Zhongliang & Dong, Wanyue & Chen, Xi, 2023. "Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China," GLO Discussion Paper Series 1309, Global Labor Organization (GLO).
    5. Lu, Liyong & Pan, Jay, 2019. "The association of hospital competition with inpatient costs of stroke: Evidence from China," Social Science & Medicine, Elsevier, vol. 230(C), pages 234-245.
    6. Li Wang & Huan Shi & Lu Gan, 2018. "Healthcare Facility Location-Allocation Optimization for China’s Developing Cities Utilizing a Multi-Objective Decision Support Approach," Sustainability, MDPI, vol. 10(12), pages 1-22, December.
    7. Zhicheng Zheng & Haoming Xia & Shrinidhi Ambinakudige & Yaochen Qin & Yang Li & Zhixiang Xie & Lijun Zhang & Haibin Gu, 2019. "Spatial Accessibility to Hospitals Based on Web Mapping API: An Empirical Study in Kaifeng, China," Sustainability, MDPI, vol. 11(4), pages 1-14, February.
    8. Jia, Peng & Wang, Youfa & Yang, Min & Wang, Limin & Yang, Xuchao & Shi, Xinyu & Yang, Lijian & Wen, Jin & Liu, Yi & Yang, Maokang & Xin, Junguo & Zhang, Fengying & Jiang, Lihua & Chi, Chunhua & Zhang,, 2022. "Inequalities of spatial primary healthcare accessibility in China," Social Science & Medicine, Elsevier, vol. 314(C).
    9. Wantong Xu & Fuguang Zhang & Biao Zeng & Taibao Yang & Hui Wang, 2019. "Spatial Access to Medical Services in the Underdeveloped Region of Northwestern China: A Case Study in Lanzhou City," Sustainability, MDPI, vol. 11(23), pages 1-14, November.
    10. Liu, Yun & Kong, Qingxia & de Bekker-Grob, Esther W., 2019. "Public preferences for health care facilities in rural China: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    11. Yang, Nan & Shen, Liyin & Shu, Tianheng & Liao, Shiju & Peng, Yi & Wang, Jinhuan, 2021. "An integrative method for analyzing spatial accessibility in the hierarchical diagnosis and treatment system in China," Social Science & Medicine, Elsevier, vol. 270(C).
    12. Lin, Xiaojun & Lu, Liyong & Pan, Jay, 2021. "Hospital market competition and health technology diffusion: An empirical study of laparoscopic appendectomy in China," Social Science & Medicine, Elsevier, vol. 286(C).
    13. Willberg, Elias & Fink, Christoph & Toivonen, Tuuli, 2023. "The 15-minute city for all? – Measuring individual and temporal variations in walking accessibility," Journal of Transport Geography, Elsevier, vol. 106(C).
    14. Kelobonye, Keone & Zhou, Heng & McCarney, Gary & Xia, Jianhong (Cecilia), 2020. "Measuring the accessibility and spatial equity of urban services under competition using the cumulative opportunities measure," Journal of Transport Geography, Elsevier, vol. 85(C).
    15. Bec, Caroline & Wells, Geoff, 2020. "Structural barriers to health-provider training programmes for ethnic minorities: the case of the Katu and diabetes management in Vietnam," SocArXiv s78xa, Center for Open Science.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:209:y:2018:i:c:p:14-24. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.