IDEAS home Printed from https://ideas.repec.org/a/gam/jsusta/v17y2025i17p7606-d1730887.html
   My bibliography  Save this article

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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2071-1050/17/17/7606/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/2071-1050/17/17/7606/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bangyu Liu & Ning Qiu & Tianjie Zhang, 2023. "Accessibility of Elderly Care Facilities Based on Social Stratification: A Case Study in Tianjin, China," Sustainability, MDPI, vol. 15(2), pages 1-12, January.
    2. Radney, Angelise & Lee, Joyce Y. & Xu, Amy & Steinke, Hannah R. & Mengo, Cecilia & Johnson-Motoyama, Michelle, 2024. "Racial and ethnic disparities in healthcare utilization among children in U.S. foster care: Recommendations to challenge the status quo based on a scoping review," Children and Youth Services Review, Elsevier, vol. 162(C).
    3. Yongqing Dong & Liping Fu & Ronghui Tan & Liman Ding, 2019. "The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area," IJERPH, MDPI, vol. 16(16), pages 1-18, August.
    4. Cheryl Dye & Deborah Willoughby & Begum Aybar-Damali & Carmelita Grady & Rebecca Oran & Alana Knudson, 2018. "Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching," IJERPH, MDPI, vol. 15(4), pages 1-23, April.
    5. Jorge Quijada-Alarcón & Roberto Rodríguez-Rodríguez & Nicoletta González-Cancelas & Gabriel Bethancourt-Lasso, 2023. "Spatial Analysis of Territorial Connectivity and Accessibility in the Province of Coclé in Panama," Sustainability, MDPI, vol. 15(15), pages 1-21, July.
    6. Jie Ding & Zhengdong Gao & Shanshan Ma, 2022. "Understanding Social Spaces in Tourist Villages through Space Syntax Analysis: Cases of Villages in Huizhou, China," Sustainability, MDPI, vol. 14(19), pages 1-18, September.
    7. Donna L. Schminkey & Xiaoyue Liu & Sandra Annan & Erika Metzler Sawin, 2019. "Contributors to Health Inequities in Rural Latinas of Childbearing Age: An Integrative Review Using an Ecological Framework," SAGE Open, , vol. 9(1), pages 21582440188, January.
    8. Zhou, Chang & Tian, Qiong & Wang, David Z.W., 2022. "A novel control strategy in mitigating bus bunching: Utilizing real-time information," Transport Policy, Elsevier, vol. 123(C), pages 1-13.
    9. repec:osf:osfxxx:ev6r2_v1 is not listed on IDEAS
    10. Ortiz, Gabriela & Rodriguez, Sophia & Pozar, María & Moran, Ashley & Cheney, Ann, 2024. "Seeking care across the US-Mexico border: The experiences of Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress," Social Science & Medicine, Elsevier, vol. 347(C).
    11. David Londoño & Héctor M. Posada, 2025. "The effects of local street integration on housing quality: the case of Medellín, Colombia," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 74(1), pages 1-24, March.
    12. Rashid A. Mushkani & Haruka Ono, 2021. "Spatial Equity of Public Parks: A Case Study of Kabul City, Afghanistan," Sustainability, MDPI, vol. 13(3), pages 1-13, February.
    13. Zhenwei Wang & Xiaochun Wang & Zijin Dong & Lisan Li & Wangjun Li & Shicheng Li, 2023. "More Urban Elderly Care Facilities Should Be Placed in Densely Populated Areas for an Aging Wuhan of China," Land, MDPI, vol. 12(1), pages 1-13, January.
    14. Ren, Jingqiu & Earl, Ryan & Amaral, Ernesto F. L., 2022. "Novel Healthcare Model, Continuation of Inequality: Exploring the Role of Micro Hospitals in Texas Healthcare Access Through Demographic Spatial Modeling," OSF Preprints ev6r2, Center for Open Science.
    15. Huicheng Feng & Xiaoxiang Tang & Cheng Zou, 2024. "Optimizing the Layout of Service Facilities for Older People Based on POI Data and Machine Learning: Guangzhou City as an Example," Land, MDPI, vol. 13(5), pages 1-15, May.
    16. Stefaniec, Agnieszka & Egan, Robert & Hosseini, Keyvan & Caulfield, Brian, 2025. "The challenge of making EVs just affordable enough: Assessing the impact of subsidies on equity and emission reduction in Ireland," Research in Transportation Economics, Elsevier, vol. 109(C).
    17. Lei Zhu & Shuang Zhong & Wei Tu & Jing Zheng & Shenjing He & Junzhe Bao & Cunrui Huang, 2019. "Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China," IJERPH, MDPI, vol. 16(2), pages 1-15, January.
    18. Meijie Chen & Yumin Chen & Xiaoguang Wang & Huangyuan Tan & Fenglan Luo, 2019. "Spatial Difference of Transit-Based Accessibility to Hospitals by Regions Using Spatially Adjusted ANOVA," IJERPH, MDPI, vol. 16(11), pages 1-20, May.
    19. Mingyuan Chang & Longyang Huang & Tianlin Zhai & Jiawei Zhu & Yuanbo Ma & Ling Li & Chenchen Zhao, 2023. "A Challenge of Sustainable Urbanization: Mapping the Equity of Urban Public Facilities in Multiple Dimensions in Zhengzhou, China," Land, MDPI, vol. 12(8), pages 1-22, August.
    20. Kestutis Zaleckis & Szymon Chmielewski & Jūratė Kamičaitytė & Indre Grazuleviciute-Vileniske & Halina Lipińska, 2022. "Walkability Compass—A Space Syntax Solution for Comparative Studies," Sustainability, MDPI, vol. 14(4), pages 1-25, February.
    21. Xintao Liu & Ziwei Lin & Jianwei Huang & He Gao & Wenzhong Shi, 2021. "Evaluating the Inequality of Medical Service Accessibility Using Smart Card Data," IJERPH, MDPI, vol. 18(5), pages 1-18, March.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    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:gam:jsusta:v:17:y:2025:i:17:p:7606-:d:1730887. 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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    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.