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

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.

A comparative study for accessing primary healthcare between planning assessment and actual utilization for older adults: a case from Dalian City, China

“…Based on the above inference, we searched parallel literature and found that most studies that have explored the gap in healthcare between potential access (supply) and realized access (utilization) focus on a large scale (city, county, or village scale) (31)(32)(33). In China, the restricting factor could be linked to the uncompleted constructed database at the community level and undisclosed information of CHCs (private or publicprivate partnership).…”

Spatial-Performance Evaluation of Primary Health Care Facilities: Evidence from Xi’an, China

“…H-H matching spaces located in central areas have a concentrated elderly population and relatively abundant medical facilities. However, L-L matching spaces in the suburbs have a smaller population, especially for the elderly population, and relatively scarce facilities [44,46,50,51]. Additionally, the number of L-L spatial units is 1.5 times that of H-H spatial units, which is closely related to the expansion model being implemented in the central area with limited land resources and the conversion of large amounts of agricultural land to suburban development.…”

Spatio-temporal pattern, matching level and prediction of ageing and medical resources in China

“…For example, the "integration of medical treatment and elderly support" reform promotes the embedding of medical and health services into the community and institutional care for the elderly [ 12 ]. Recent reforms in public hospitals and the construction of a hierarchical healthcare system have provided a strong impetus for the development of senior healthcare [ 13 ]. To a certain extent, these reforms have the potential to mitigate the the healthcare demands of the ageing population, enhance the prioritization of elderly patients, and optimize the utilization of medical resources for the elderly.…”