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. 2023 Jan 3;20(1):890.
doi: 10.3390/ijerph20010890.

Assessing Spatial Accessibility of Community Hospitals for the Elderly in Beijing, China

Jingya Luan  1 , Yuhong Tian  1 , Chi Yung Jim  2 , Xu Liu  3 , Mengxuan Yan  1 , Lizhu Wu  1
Affiliations

Assessing Spatial Accessibility of Community Hospitals for the Elderly in Beijing, China

Jingya Luan et al. Int J Environ Res Public Health. .

Abstract

Accessibility of health services signifies the quality and equitability of universal health provision. The hierarchical medical system recently implemented in China offers the policy instruments to improve medical services to the elderly in an aging society. As the critical primary care gateway, accessibility to community hospitals has significant impacts on people's health. However, current research has paid little attention to spatial accessibility within walking distance of community hospitals, especially for the elderly. This study selected four districts with different urbanization levels in the rapidly developing Beijing metropolis. The spatial interaction model was applied to measure the accessibility of community hospitals for the elderly at the community level. An attractiveness index was computed based on key hospital traits. The results showed that: (1) community hospitals could cover 82.66% of elderly residents, and 77.63% of the communities were within walking distance. The served elderly proportion was relatively high in central urban areas and low in the suburbs. (2) The attractiveness indices of hospitals varied notably between districts, with higher values in more urbanized areas. (3) The spatial accessibility for the elderly of hospitals differed significantly between the four districts, with a descending gradient from central to suburban and rural areas, as indicated by the Gini coefficients and Lorenz curves. (4) The accessibility index was strongly related to the served elderly population and the hospital-residence distance. The findings provide policy directions to the government, including providing more primary-care resources to suburban and rural areas, building new community hospitals in identified provision gaps, upgrading some clinics to hospitals in rural areas, and planning hospitals according to the projected trend of the elderly population in terms of quantity and distribution. The considerable provision disparity between core urban, suburban and rural areas can be addressed by refined spatial health planning informed by research.

Keywords: Beijing; aged population; community hospital; health equity; spatial accessibility; spatial interaction model (SIM).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The conceptual framework for accessibility.
Figure 2
Figure 2
Distribution of community hospitals and the aged population in the study areas in Beijing.
Figure 3
Figure 3
Walking distances to community hospitals in four districts.
Figure 4
Figure 4
Attractiveness index of community hospitals within walking distance of four districts.
Figure 5
Figure 5
Accessibility index of community hospitals within walking distance of four districts.
Figure 6
Figure 6
Lorenz curves and Gini coefficients for spatial accessibility of community hospitals by the aged population in four districts.
See this image and copyright information in PMC

References

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