Urban and rural disparities in general hospital accessibility within a Chinese metropolis.
China
Inequality
Metropolis
Spatial accessibility
Urban–rural relationship
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
07 Oct 2024
07 Oct 2024
Historique:
received:
19
02
2024
accepted:
30
09
2024
medline:
8
10
2024
pubmed:
8
10
2024
entrez:
7
10
2024
Statut:
epublish
Résumé
Accessibility is one of the crucial criteria for measuring the ease of access to public services in a region. Given China's historical rural-urban dualism and rapid urbanization process, there exist significant disparities in public services within metropolises. This study selects Nanjing as a representative metropolis and employs the Gaussian two-step floating catchment area method and an improved potential model to calculate the accessibility of comprehensive hospitals. Spatial autocorrelation and urban-rural disparities are analyzed, confirming spatial variations in healthcare service equity. The results show that: ①The spatial variability of accessibility to comprehensive hospitals is significant. The Gaussian two-step floating catchment method overestimates overall accessibility, and for Nanjing, the improved potential model with β = 1.5 proves more suitable. ②Accessibility exhibits pronounced clustering characteristics. Healthcare conditions for residents in the northern part of Liuhe District, eastern part of Qixia District, western part of Pukou District, peripheral areas of Jiangning District, eastern part of Gaochun District, and residents in Lishui District need improvement. ③Comprehensive healthcare services are relatively lacking in nearly 60% of rural areas. Our research findings provide valuable insights for improving spatial justice in public infrastructure in metropolises of developing countries.
Identifiants
pubmed: 39375421
doi: 10.1038/s41598-024-74816-4
pii: 10.1038/s41598-024-74816-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
23359Subventions
Organisme : Special funds for basic scientific research business of central public welfare research institutes
ID : G2024-18-1，1610132023015, G2024-01-17，GJ2024-18-4
Informations de copyright
© 2024. The Author(s).
Références
Weiss, D. J. et al. Global maps of travel time to healthcare facilities. Nat. Med. https://doi.org/10.1038/s41591-020-1059-1 (2020).
doi: 10.1038/s41591-020-1059-1
pubmed: 32989313
pmcid: 7018602
Burger, R. & Christian, C. Access to health care in post-apartheid South Africa: availability, affordability, acceptability. Health Econ. Policy Law15, 43–55. https://doi.org/10.1017/S1744133118000300 (2020).
doi: 10.1017/S1744133118000300
pubmed: 29996951
Tao, Z. L., Cheng, Y. & Liu, J. X. Hierarchical two-step floating catchment area (2SFCA) method: measuring the spatial accessibility to hierarchical healthcare facilities in Shenzhen, China. Int. J. Equity Health https://doi.org/10.1186/s12939-020-01280-7 (2020).
doi: 10.1186/s12939-020-01280-7
pubmed: 32957992
pmcid: 7507269
Boakye, J., Guidotti, R., Gardoni, P. & Murphy, C. The role of transportation infrastructure on the impact of natural hazards on communities. Reliab. Eng. Syst. Safe. https://doi.org/10.1016/j.ress.2021.108184 (2022).
doi: 10.1016/j.ress.2021.108184
Lu, C., Zhang, Z. X. & Lan, X. T. Impact of China’s referral reform on the equity and spatial accessibility of healthcare resources: A case study of Beijing. Soc. Sci. Med. https://doi.org/10.1016/j.socscimed.2019.112386 (2019).
doi: 10.1016/j.socscimed.2019.112386
pubmed: 31683116
Liu, D., Kwan, M. P. & Kan, Z. H. Analyzing disparities in transit-based healthcare accessibility in the Chicago Metropolitan Area. Canad. Geographer-Geographe Canadien66, 248–262. https://doi.org/10.1111/cag.12708 (2022).
doi: 10.1111/cag.12708
Jia, P. et al. Inequalities of spatial primary healthcare accessibility in China. Soc. Sci. Med. https://doi.org/10.1016/j.socscimed.2022.115458 (2022).
doi: 10.1016/j.socscimed.2022.115458
pubmed: 36279792
Lahariya, C. Health & wellness centers to strengthen primary health care in India: concept, progress and ways forward. Indian J. Pediatr.87, 916–929. https://doi.org/10.1007/s12098-020-03359-z (2020).
doi: 10.1007/s12098-020-03359-z
pubmed: 32638338
pmcid: 7340764
Ahmed, S. et al. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements. BMJ Global Health https://doi.org/10.1136/bmjgh-2020-003042 (2020).
doi: 10.1136/bmjgh-2020-003042
pubmed: 33272939
pmcid: 7716661
Baxter, D. & Casady, C. B. Proactive and strategic healthcare public-private partnerships (PPPs) in the coronavirus (Covid-19) epoch. Sustainability https://doi.org/10.3390/su12125097 (2020).
doi: 10.3390/su12125097
Park, J., Michels, A., Lyu, F., Han, S. Y. & Wang, S. W. Daily changes in spatial accessibility to ICU beds and their relationship with the case-fatality ratio of COVID-19 in the state of Texas, USA. Appl. Geogr. https://doi.org/10.1016/j.apgeog.2023.102929 (2023).
doi: 10.1016/j.apgeog.2023.102929
pubmed: 36960405
pmcid: 10011039
Gu, Z. N., Luo, X. L., Tang, M. & Liu, X. M. Does the edge effect impact the healthcare equity? An examination of the equity in hospitals accessibility in the edge city in multi-scale. J. Transp. Geogr. https://doi.org/10.1016/j.jtrangeo.2022.103513 (2023).
doi: 10.1016/j.jtrangeo.2022.103513
Contreras, D., Bhamidipati, S. & Wilkinson, S. Social vulnerability and spatial inequality in access to healthcare facilities: The case of the Santiago Metropolitan Region (RMS), Chile. Socio-Econ. Plann. Sci. https://doi.org/10.1016/j.seps.2023.101735 (2023).
doi: 10.1016/j.seps.2023.101735
Kim, J. et al. Developing and evaluating transit-based healthcare accessibility in a low- and middle-income country: A case study in Ulaanbaatar, Mongolia. Habitat Int https://doi.org/10.1016/j.habitatint.2022.102729 (2023).
doi: 10.1016/j.habitatint.2022.102729
Dumedah, G. et al. Characterizing the geography of potential healthcare accessibility in informal settlements in the Greater Kumasi area of Ghana. Afr. Geogr. Rev.42, 46–71. https://doi.org/10.1080/19376812.2021.1991811 (2023).
doi: 10.1080/19376812.2021.1991811
Chi, Z. & Han, H. Urban-rural differences: The impact of social support on the use of multiple healthcare services for older people. Front. Public Health https://doi.org/10.3389/fpubh.2022.851616 (2022).
doi: 10.3389/fpubh.2022.851616
pubmed: 36339185
pmcid: 9634651
Sritart, H., Tuntiwong, K., Miyazaki, H. & Taertulakarn, S. Disparities in healthcare services and spatial assessments of mobile health clinics in the border regions of Thailand. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph182010782 (2021).
doi: 10.3390/ijerph182010782
pubmed: 34682527
pmcid: 8535297
Du, M. G. & Zhao, S. C. An equity evaluation on accessibility of primary healthcare facilities by using V2SFCA Method: Taking Fukuoka City, Japan, as a Case Study. Land https://doi.org/10.3390/land11050640 (2022).
doi: 10.3390/land11050640
Guhlincozzi, A. R. Making visible the Chicagoland suburban healthcare landscape of latina women: a qualitative GIS approach. Soc. Cult. Geogr.25, 275–294. https://doi.org/10.1080/14649365.2022.2139857 (2024).
doi: 10.1080/14649365.2022.2139857
Dahab, R. & Sakellariou, D. Barriers to accessing maternal care in low income Countries in Africa: A systematic review. Int. J. Environ. Res Public Health https://doi.org/10.3390/ijerph17124292 (2020).
doi: 10.3390/ijerph17124292
pubmed: 32560132
pmcid: 7344902
Cheng, L., Yang, M., De Vos, J. & Witlox, F. Examining geographical accessibility to multi-tier hospital care services for the elderly: A focus on spatial equity. J. Transp. Health https://doi.org/10.1016/j.jth.2020.100926 (2020).
doi: 10.1016/j.jth.2020.100926
Zhao, P. J., Li, S. X. & Liu, D. Unequable spatial accessibility to hospitals in developing megacities: New evidence from Beijing. Health Place https://doi.org/10.1016/j.healthplace.2020.102406 (2020).
doi: 10.1016/j.healthplace.2020.102406
pubmed: 33302122
pmcid: 7568172
Liu, P. Y., Bai, X. & Ravenscroft, N. Counterurbanization, gentrification and the potential for rural revitalisation in China. Popul. Space Place https://doi.org/10.1002/psp.2680 (2023).
doi: 10.1002/psp.2680
Tao, Z. L. & Han, W. C. Assessing the impacts of hierarchical healthcare system on the accessibility and spatial equality of healthcare services in Shenzhen, China. ISPRS Int. J. Geo-Inform. https://doi.org/10.3390/ijgi10090615 (2021).
doi: 10.3390/ijgi10090615
Gong, S. Z. et al. Evaluating healthcare resource inequality in Beijing, China based on an improved spatial accessibility measurement. T Gis25, 1504–1521. https://doi.org/10.1111/tgis.12737 (2021).
doi: 10.1111/tgis.12737
Kazazi, A. K., Amiri, F., Rahmani, Y., Samouei, R. & Rabiei-Dastjerdi, H. A new hybrid model for mapping spatial accessibility to healthcare services using machine learning methods. Sustainability https://doi.org/10.3390/su142114106 (2022).
doi: 10.3390/su142114106
Banke-Thomas, A., Wong, K. L. M., Ayomoh, F. I., Giwa-Ayedun, R. O. & Benova, L. “In cities, it’s not far, but it takes long”: comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria. BMJ Global Health https://doi.org/10.1136/bmjgh-2020-004318 (2021).
doi: 10.1136/bmjgh-2020-004318
pubmed: 34615663
pmcid: 8496383
Tao, Z. L., Yao, Z. X., Kong, H., Duan, F. & Li, G. C. Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs. BMC Health Serv. Res. https://doi.org/10.1186/s12913-018-3132-8 (2018).
doi: 10.1186/s12913-018-3132-8
pubmed: 30376828
pmcid: 6208024
Sabokbar, H. F., Mohammadi, H., Tahmasbi, S., Rafii, Y. & Hosseini, A. Measuring spatial accessibility and equity to healthcare services using fuzzy inference system. Appl. Geogr. https://doi.org/10.1016/j.apgeog.2021.102584 (2021).
doi: 10.1016/j.apgeog.2021.102584
Majumder, S., Roy, S., Bose, A. & Chowdhury, I. R. Understanding regional disparities in healthcare quality and accessibility in West Bengal, India: A multivariate analysis. Reg. Sci. Policy Practice15, 1086–1113. https://doi.org/10.1111/rsp3.12607 (2023).
doi: 10.1111/rsp3.12607
Dejen, A., Soni, S. & Semaw, F. Spatial accessibility analysis of healthcare service centers in Gamo Gofa Zone, Ethiopia through Geospatial technique. Remote Sens. Appl.-Soc. Environ.13, 466–473. https://doi.org/10.1016/j.rsase.2019.01.004 (2019).
doi: 10.1016/j.rsase.2019.01.004
Zafri, N. M., Nurullah, M., Neema, M. N. & Waliullah, M. Spatial accessibility to healthcare facilities in coastal region of Bangladesh. Int. J. Health Plann. Manage.36, 643–655. https://doi.org/10.1002/hpm.3107 (2021).
doi: 10.1002/hpm.3107
pubmed: 33393141
Lee, S. Spatial and socioeconomic inequalities in accessibility to healthcare services in South Korea. Healthcare https://doi.org/10.3390/healthcare10102049 (2022).
doi: 10.3390/healthcare10102049
pubmed: 36611582
pmcid: 9819428
Chen, B. Y., Cheng, X. P., Kwan, M. P. & Schwanen, T. Evaluating spatial accessibility to healthcare services under travel time uncertainty: A reliability-based floating catchment area approach. J. Transp. Geogr. https://doi.org/10.1016/j.jtrangeo.2020.102794 (2020).
doi: 10.1016/j.jtrangeo.2020.102794
Wang, J. Y. et al. Assessing the spatial accessibility of urban medical facilities in multi-level and multi-period scales based on web mapping API and an improved potential model. ISPRS Int. J. Geo-Inform. https://doi.org/10.3390/ijgi11110545 (2022).
doi: 10.3390/ijgi11110545
Li, J. G. et al. Spatiotemporal analysis of the relationship between urbanization and the eco-environment in the Kashgar metropolitan area, China. Ecol. Indic. https://doi.org/10.1016/j.ecolind.2021.108524 (2022).
doi: 10.1016/j.ecolind.2021.108524
Zhang, S. Y., Song, X. Q. & Zhou, J. An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare. Int. J. Equity Health https://doi.org/10.1186/s12939-021-01553-9 (2021).
doi: 10.1186/s12939-021-01553-9
pubmed: 34774038
pmcid: 8590288
Tang, J. H., Chiu, Y. H., Chiang, P. H., Su, M. D. & Chan, T. C. A flow-based statistical model integrating spatial and nonspatial dimensions to measure healthcare access. Health Place47, 126–138. https://doi.org/10.1016/j.healthplace.2017.08.006 (2017).
doi: 10.1016/j.healthplace.2017.08.006
pubmed: 28881229
Ni, J. H., Liang, M., Lin, Y., Wu, Y. L. & Wang, C. Multi-mode two-step floating catchment area (2SFCA) method to measure the potential spatial accessibility of healthcare services. ISPRS Int. J. Geo-Inform. https://doi.org/10.3390/ijgi8050236 (2019).
doi: 10.3390/ijgi8050236
Khashoggi, B. F. & Murad, A. Use of 2SFCA method to identify and analyze spatial access disparities to healthcare in Jeddah, Saudi Arabia. Appl. Sci.-Basel https://doi.org/10.3390/app11209537 (2021).
doi: 10.3390/app11209537
Fu, L., Wang, Y., Zeng, B., Mao, Y. & Gao, M. Spatial accessibility of medical facilities in Beibei district based on modified two-step floating catchment area method. J. Geo-Inform. Sci.21, 1565–1575 (2019).
Li, Y., Xie, Y., Sun, S. & Hu, L. Evaluation of park accessibility based on improved gaussian two-step floating catchment area method: A case study of Xi’an city. Buildings https://doi.org/10.3390/buildings12070871 (2022).
doi: 10.3390/buildings12070871
Tong, D., Sun, Y. & Xie, M. Evaluation of green space accessibility based on improved Gaussian two-step floating catchment area method: A case study of Shenzhen City, China. Adv. Earth Sci.36, 1113–1126 (2021).
Guo, C. & Liang, J. Accessibility analysis of medical facilities based on multiple transportation modes of network map. J. Geo-Inform. Sci.24, 483–494 (2022).
Yang, N., Chen, S. Y., Hu, W. L., Wu, Z. G. & Chao, Y. Spatial distribution balance analysis of hospitals in Wuhan. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph13100971 (2016).
doi: 10.3390/ijerph13100971
pubmed: 28009850
pmcid: 5201409
Peeters, D. & Thomas, I. Distance predicting functions and applied location-allocation models. J. Geogr. Syst.2, 167–184. https://doi.org/10.1007/PL00011453 (2000).
doi: 10.1007/PL00011453
Tao, Z. L. & Wang, Q. Facility or transport inequality? Decomposing healthcare accessibility inequality in Shenzhen, China. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph19116897 (2022).
doi: 10.3390/ijerph19116897
pubmed: 36613070
pmcid: 9819840
Liu, L. Y., Porr, A. & Miller, H. J. Realizable accessibility: evaluating the reliability of public transit accessibility using high-resolution real-time data. J. Geogr. Syst.25, 429–451. https://doi.org/10.1007/s10109-022-00382-w (2023).
doi: 10.1007/s10109-022-00382-w
Xiao, W. Y., Wei, Y. H. D. & Wan, N. Modeling job accessibility using online map data: An extended two-step floating catchment area method with multiple travel modes. J. Transp. Geogr. https://doi.org/10.1016/j.jtrangeo.2021.103065 (2021).
doi: 10.1016/j.jtrangeo.2021.103065
Ma, X. Y. et al. Incorporating multiple travel modes into a floating catchment area framework to analyse patterns of accessibility to hierarchical healthcare facilities. J. Transp. Health https://doi.org/10.1016/j.jth.2019.100675 (2019).
doi: 10.1016/j.jth.2019.100675
Cheng, G. et al. Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen, China. Habitat Int.53, 485–494. https://doi.org/10.1016/j.habitatint.2015.12.023 (2016).
doi: 10.1016/j.habitatint.2015.12.023
Tao, Z. L., Cheng, Y., Zheng, Q. J. & Li, G. C. Measuring spatial accessibility to healthcare services with constraint of administrative boundary: a case study of Yanqing District, Beijing, China. Int. J. Equity. Health https://doi.org/10.1186/s12939-018-0720-5 (2018).
doi: 10.1186/s12939-018-0720-5
pubmed: 30249270
pmcid: 6154887
Zhang Lixian, C. B. F. U. H. X. U. B. R. E. N. Z. G. P. (ed Center National Tibetan Plateau Data) (National Tibetan Plateau Data Center, 2021).
Reggiani, A., Bucci, P. & Russo, G. Accessibility and impedance forms: Empirical applications to the German commuting network. Int. Reg. Sci. Rev.34, 230–252. https://doi.org/10.1177/0160017610387296 (2010).
doi: 10.1177/0160017610387296
Wang, F. H. From 2SFCA to i2SFCA: Integration, derivation and validation. Int. J. Geogr. Inf. Sci.35, 628–638. https://doi.org/10.1080/13658816.2020.1811868 (2021).
doi: 10.1080/13658816.2020.1811868
pubmed: 33732091
Jones, P. & Lucas, K. The social consequences of transport decision-making: clarifying concepts, synthesising knowledge and assessing implications. J. Transp. Geogr.21, 4–16. https://doi.org/10.1016/j.jtrangeo.2012.01.012 (2012).
doi: 10.1016/j.jtrangeo.2012.01.012