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Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China

Author

Listed:
  • Kan Wang

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

  • Jianjun Bai

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

  • Xing Dang

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

Abstract

The contradiction between the supply and demand of public medical resources in China is serious. On the basis of the “graded diagnosis and treatment” model, the Chinese government divides the medical grade and adjusts the allocation of medical facilities so as to alleviate the adverse impact of these issues on residents’ health. Although the government tries to guide residents’ medical treatment according to the level of medical facilities, there are differences between residents’ medical treatment mode and policy rules in reality. Therefore, it is of great significance to explore spatial differences in accessibility to medical services for residents on the basis of the actual medical behavior. This article takes Shaanxi province as the research area, and uses the improved node cost network analysis method with the space-time distance model and the two-step floating catchment area method, respectively, to analyze the spatial differences of accessibility to three-level medical services and evaluate the equity of accessibility in different areas and groups in Shaanxi. Results showed that the overall level of accessibility to primary medical services in the province is good, and spatial distribution is balanced; the polarization of accessibility to secondary and tertiary medical services is a serious issue, and within the research area, a band-shaped multicore spatial structure was formed with the built-up areas of various cities as high-level centers of accessibility. Provincial residents have poor equity to access three-level medical services, and the equity of accessibility to primary medical services is better than that to highly specialized medical services. There is no obvious gap between accessibility to three-level medical services for the aging and the nonaging populations in Shaanxi, but the unfair phenomenon between agricultural and the nonagricultural populations is prominent. In addition, this article found that the improvement in traffic conditions can produce space-time convergence and effectively weaken spatial deprivation. Therefore, developing public transportation is an effective approach to improve the equity of accessibility to medical services.

Suggested Citation

  • Kan Wang & Jianjun Bai & Xing Dang, 2020. "Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China," IJERPH, MDPI, vol. 18(1), pages 1-20, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2020:i:1:p:112-:d:468641
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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. Liu, Liwen & Zhang, Ming, 2018. "High-speed rail impacts on travel times, accessibility, and economic productivity: A benchmarking analysis in city-cluster regions of China," Journal of Transport Geography, Elsevier, vol. 73(C), pages 25-40.
    3. Kelobonye, Keone & McCarney, Gary & Xia, Jianhong (Cecilia) & Swapan, Mohammad Shahidul Hasan & Mao, Feng & Zhou, Heng, 2019. "Relative accessibility analysis for key land uses: A spatial equity perspective," Journal of Transport Geography, Elsevier, vol. 75(C), pages 82-93.
    4. Tianlu Qian & Jie Chen & Ang Li & Jiechen Wang & Dingtao Shen, 2020. "Evaluating Spatial Accessibility to General Hospitals with Navigation and Social Media Location Data: A Case Study in Nanjing," IJERPH, MDPI, vol. 17(8), pages 1-16, April.
    5. Karen Lucas & Bert Wee & Kees Maat, 2016. "A method to evaluate equitable accessibility: combining ethical theories and accessibility-based approaches," Transportation, Springer, vol. 43(3), pages 473-490, May.
    6. 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.
    7. Sunwei Liu & Yupeng Wang & Dian Zhou & Yitong Kang, 2020. "Two-Step Floating Catchment Area Model-Based Evaluation of Community Care Facilities’ Spatial Accessibility in Xi’an, China," IJERPH, MDPI, vol. 17(14), pages 1-17, July.
    8. Guzman, Luis A. & Oviedo, Daniel & Rivera, Carlos, 2017. "Assessing equity in transport accessibility to work and study: The Bogotá region," Journal of Transport Geography, Elsevier, vol. 58(C), pages 236-246.
    9. Wei Hu & Lin Li & Mo Su, 2019. "Spatial Inequity of Multi-Level Healthcare Services in a Rapid Expanding Immigrant City of China: A Case Study of Shenzhen," IJERPH, MDPI, vol. 16(18), pages 1-16, September.
    10. Gerardo Carpentieri & Carmen Guida & Houshmand E. Masoumi, 2020. "Multimodal Accessibility to Primary Health Services for the Elderly: A Case Study of Naples, Italy," Sustainability, MDPI, vol. 12(3), pages 1-15, January.
    11. Delbosc, Alexa & Currie, Graham, 2011. "Using Lorenz curves to assess public transport equity," Journal of Transport Geography, Elsevier, vol. 19(6), pages 1252-1259.
    12. Wei Chiang Chan & Wan Hashim Wan Ibrahim & May Chiun Lo & Mohamad Kadim Suaidi & Shiaw Tong Ha, 2020. "Sustainability of Public Transportation: An Examination of User Behavior to Real-Time GPS Tracking Application," Sustainability, MDPI, vol. 12(22), pages 1-20, November.
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    1. Huanhuan Zhu & Lin Pan & Yiji Li & Huiming Jin & Qian Wang & Xin Liu & Cong Wang & Peng Liao & Xinyang Jiang & Luo Li, 2021. "Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China," IJERPH, MDPI, vol. 18(19), pages 1-17, September.

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