Examining Spatial Accessibility and Equity of Public Hospitals for Older Adults in Songjiang District, Shanghai

Abstract

In developing countries, aging is rapid and new towns in suburban and rural districts are emerging. However, the spatial accessibility and equity of healthcare services for older adults in new towns is rarely examined. This study is among the earliest attempts to evaluate the spatial accessibility and equity of public hospitals for older adults, using data from Songjiang District, Shanghai, China. A modified Gaussian Huff-based three-step floating catchment area (GH3SFCA) method was adopted based on the real-time travel costs of public transit, driving, cycling, and walking. The Gini coefficient and Bivariate Moran’s Index were integrated to estimate spatial equity. The results showed that the spatial accessibility of high-tier hospitals decreases from the central areas to the outskirts for older adults in Songjiang. Meanwhile, the accessibility of low-tier hospitals varies substantially across areas. Although the low-tier hospitals are distributed evenly, their Gini coefficient showed less equitable spatial accessibility than the high-tier hospitals. Furthermore, driving and cycling lead to more equitable spatial accessibility than public transit or walking. Finally, communities with a low-supply–high-demand mismatch for public hospitals were suggested to be improved preferentially. These findings will facilitate planning strategies for public hospitals for older adults in developing new towns.