Assessing Spatial Accessibility to Primary Health Care Services in Beijing, China.

Jiawei Zhang,Peien Han,Li Yang,Yan Sun,Jingyu Zhao

doi:10.3390/ijerph182413182

Jiawei Zhang, Peien Han + Show 3 more

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https://doi.org/10.3390/ijerph182413182

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Abstract

Primary health care has been emphasized as a pillar of China’s current round of health reforms throughout the previous decade. The purpose of this study is to analyze the accessibility of primary health care services in Beijing and to identify locations with a relative scarcity of health personnel. Seven ecological conservation districts, which are relatively underdeveloped, were selected in the study. The Gini coefficient and Lorenz curve, as well as the shortest trip time and modified two-step floating catchment area (M2SFCA) approach, are used to quantify inequalities in primary health care resources and spatial accessibility. The Gini coefficient of primary medical services was calculated as high as 0.705, showing a significant disparity in primary care services. A total of 81.22% of communities reached the nearest primary care institution within 15 min. The average accessibility of primary healthcare services, as measured by the number of health professionals per 1000 population, was 2.34 in the 1715 communities of seven ecological conservation districts. Three hundred and ninety-one communities (22.80%) were identified with relatively low accessibility. More primary health professionals should be allocated to Miyun, Mentougou, and Changping Districts. Overall, the primary healthcare resources were distributed unevenly in most districts. According to our study, expanding primary healthcare institutions, increasing the number of competent health professionals, and enhancing road networks will all be effective ways to increase spatial accessibility and reduce primary healthcare service disparity in Beijing.

Highlights

In 1981, Penchansky and Thomas defined [1] the influencing factors of medical services as “5 A”s, namely availability, accessibility, affordability, acceptability, and accommodation Figure 1
To provide accurate assessment and efficient improvement of primary healthcare resources, this study focuses on these 7 ecological conservation districts
More than 75% of people shared only approximately 25% of the According to the figure, more than 75% of people shared only approximately 25% of the spatial accessibility, while the remaining less than 25% had three times as many resources spatial accessibility, while the remaining less than 25% had three times as many resources as the former, indicating that the spatial distribution of medical resources in the area we as the former, indicating that the spatial distribution of medical resources in the area we studied is uneven

Summary

Introduction

In 1981, Penchansky and Thomas defined [1] the influencing factors of medical services as “5 A”s, namely availability, accessibility, affordability, acceptability, and accommodation Figure 1. Accessibility mainly considers spatial accessibility and nonspatial accessibility [2]. Spatial accessibility is primarily concerned with the distribution of population (demand) and medical facilities (supply) in space. Nonspatial accessibility takes into account demographic and socioeconomic variables such as age, gender, and income. As demand for medical services grows and medical services acquire more distinct spatial characteristics, an increasing number of studies have examined the equity and rationality of medical resource allocation, with the research findings providing more realistic guidance for policymakers [3]. The spatial distribution of medical services has a significant impact on residents’ access to medical services

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