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Multi-Dimensional Accessibility Framework for Nursing Home Planning: Insights from Kunming, China

Author

Listed:
  • Wenlei Ding

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China)

  • Genyu Xu

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China
    State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China)

  • Jian Xu

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China)

  • Shigeki Matsubara

    (Department of Global Architecture, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan)

  • Ruiqu Ma

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China)

  • Ming Ma

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China
    Institute for Smart City of Chongqing University in Liyang, Chongqing University, Liyang 213300, China
    Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China)

  • Houjun Li

    (School of Architecture and Planning, Yunnan University, Kunming 650500, China)

Abstract

Rapid population aging in developing countries has intensified demand for accessible nursing home services, yet spatial disparities in service distribution remain insufficiently examined in secondary cities. This study investigates spatial distribution and multi-dimensional accessibility of nursing homes in Kunming, China, using comprehensive spatial analytical methods to inform sustainable urban development. We analyzed 205 nursing homes with 47,600 beds, evaluating spatial distribution patterns, economic accessibility, and spatial accessibility across different transportation modes. Our analysis reveals a pronounced monocentric pattern with nursing resources concentrated within central urban districts, creating a “primary core-multiple satellite” structure and spatial mismatch between service supply and older adult population needs. A distinct institutional dichotomy exists between publicly and privately operated facilities, establishing a dual-track system with different accessibility implications for social equity. Economic accessibility analysis demonstrates significant barriers in central urban and tourism-oriented districts dominated by higher-priced private facilities, where minimum prices frequently exceed average monthly pension. Spatial accessibility remains inadequate across all transportation modes, with only 24.3% of communities achieving normal or higher accessibility via private car, 21.5% via public bus, and merely 13.9% via walking. These limitations primarily stem from insufficient service capacity (34 beds per 1000 older adults) relative to demographic needs rather than transportation constraints. We recommend three sustainable interventions: implementing demand-based planning mechanisms, establishing progressive pricing policies, and developing older adult-friendly transportation networks. This framework supports sustainable urbanization by promoting spatial equity and efficient resource allocation, providing valuable insights for secondary cities pursuing sustainable development goals.

Suggested Citation

  • Wenlei Ding & Genyu Xu & Jian Xu & Shigeki Matsubara & Ruiqu Ma & Ming Ma & Houjun Li, 2025. "Multi-Dimensional Accessibility Framework for Nursing Home Planning: Insights from Kunming, China," Sustainability, MDPI, vol. 17(17), pages 1-27, August.
  • Handle: RePEc:gam:jsusta:v:17:y:2025:i:17:p:7606-:d:1730887
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    References listed on IDEAS

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    1. Jing Luo & Guangping Chen & Chang Li & Bingyan Xia & Xuan Sun & Siyun Chen, 2018. "Use of an E2SFCA Method to Measure and Analyse Spatial Accessibility to Medical Services for Elderly People in Wuhan, China," IJERPH, MDPI, vol. 15(7), pages 1-17, July.
    2. Hiranya Sritart & Kuson Tuntiwong & Hiroyuki Miyazaki & Somchat Taertulakarn, 2021. "Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand," IJERPH, MDPI, vol. 18(20), pages 1-24, October.
    3. Bo-Xun Huang & Shang-Chia Chiou & Wen-Ying Li, 2020. "Accessibility and Street Network Characteristics of Urban Public Facility Spaces: Equity Research on Parks in Fuzhou City Based on GIS and Space Syntax Model," Sustainability, MDPI, vol. 12(9), pages 1-19, April.
    4. van Heerden, Quintin & Karsten, Carike & Holloway, Jenny & Petzer, Engela & Burger, Paul & Mans, Gerbrand, 2022. "Accessibility, affordability, and equity in long-term spatial planning: Perspectives from a developing country," Transport Policy, Elsevier, vol. 120(C), pages 104-119.
    5. Xiaoran Huang & Pixin Gong & Marcus White, 2022. "Study on Spatial Distribution Equilibrium of Elderly Care Facilities in Downtown Shanghai," IJERPH, MDPI, vol. 19(13), pages 1-17, June.
    6. Caldwell, J.T. & Ford, C.L. & Wallace, S.P. & Wang, M.C. & Takahashi, L.M., 2016. "Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1463-1469.
    7. Zhuolin Tao & Yang Cheng, 2019. "Modelling the spatial accessibility of the elderly to healthcare services in Beijing, China," Environment and Planning B, , vol. 46(6), pages 1132-1147, July.
    8. Mingjiu Jin & Qingtan Deng & Siyu Wang & Luteng Wei, 2023. "Equity Evaluation of Elderly-Care Institutions Based on Ga2SFCA: The Case Study of Jinan, China," Sustainability, MDPI, vol. 15(24), pages 1-25, December.
    9. Huihua Hu & Hua Shao & Yang Li & Mengfan Guan & Jiaxing Tong, 2025. "GIS-Based Analysis of Elderly Care Facility Distribution and Supply–Demand Coordination in the Yangtze River Delta," Land, MDPI, vol. 14(4), pages 1-24, March.
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