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. 2023 Mar 8;20(6):4730.
doi: 10.3390/ijerph20064730.

Influences of Spatial Accessibility and Service Capacity on the Utilization of Elderly-Care Facilities: A Case Study of the Main Urban Area of Chongqing

Jinhui Ma  1 , Haijing Huang  1   2 , Daibin Liu  3
Affiliations

Influences of Spatial Accessibility and Service Capacity on the Utilization of Elderly-Care Facilities: A Case Study of the Main Urban Area of Chongqing

Jinhui Ma et al. Int J Environ Res Public Health. .

Abstract

With the unprecedented growth of the elderly population in China, elderly-care facilities (ECFs) are in a fast expansion process. However, limited attention has been paid to the imbalance at the actual utilization level of ECFs. This research aims to reveal the spatial inequity of ECFs and to quantitatively examine the effect of accessibility and institutional service capacity on utilization. Taking Chongqing, China, as the study area, we measured the spatial accessibility of different travel modes by the Gaussian Two-Step Floating Catchment Area (G2SFCA) method and investigated distribution differences in spatial accessibility, service capacity, and utilization of ECFs by the Dagum Gini Coefficient and its decomposition. Then, the impact of spatial accessibility and service capacity on the utilization of regional ECFs was quantified by multiscale geographically weighted regression (MGWR). The study findings can be summarized as follows. (1) Walking accessibility has the most significant impact on the utilization of ECFs and shows geographic heterogeneity. Developing a pedestrian-oriented network of pathways is essential to enhance the utilization of ECFs. (2) Accessibility by driving and bus-riding does not correlate with regional ECFs utilization, and relevant studies cannot rely on them alone for assessing the equity of ECFs. (3) In the utilization of ECFs, since the inter-regional difference is more significant than the intra-regional difference, efforts to reduce the overall imbalance should be oriented toward inter-regional variation. The study's findings will assist national policymakers in developing EFCs to enhance health indicators and quality of life for older adults by prioritizing financing for shortage areas, coordinating ECFs services, and optimizing road systems.

Keywords: elderly-care facilities (ECFs); service capacity; spatial accessibility; two-step floating catchment area method; utilization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Research framework.
Figure 2
Figure 2
The geographical distribution of elder population density and ECFs in the main urban area of Chongqing.
Figure 3
Figure 3
The location and Transport network of the main urban area of Chongqing.
Figure 4
Figure 4
Spatial accessibility to ECFs under rail transit mode (a), private car mode (b), bus mode (c) and walk mode (d).
Figure 5
Figure 5
Intra-regional differences of The Dagum Gini coefficient. (a) Rail transit mode; (b) private car mode; (c) bus mode and (d) walk mode.
Figure 6
Figure 6
Inter-regional differences of The Dagum Gini coefficient. (a) Rail Transit mode; (b) private car mode; (c) bus mode and (d) walk mode.
Figure 7
Figure 7
Spatial distribution of service capacity (a) and space utilization (b).
Figure 8
Figure 8
Intra-regional differences of The Dagum Gini coefficient. (a) service capacity; (b) space utilization.
Figure 9
Figure 9
Inter-regional differences of The Dagum Gini coefficient. (a) service capacity; (b) space utilization.
Figure 10
Figure 10
Spatial distribution of regression coefficients and significance.
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