Does the edge effect impact the healthcare equity? An examination of the equity in hospitals accessibility in the edge city in multi-scale

Abstract

Regionalism and polycentricity reformed the relationship among cities and gave rise to numerous edge cities being established around a metropolis. The connection between edge cities and the metropolis has necessitated hospital sharing. Considering the features of edge cities, this study identifies the equity in hospital accessibility and examines the edge effects in an equity analysis. The Balanced Floating Catchment Areas model is applied to measure the accessibility to hospitals in a typical edge city – Kunshan, China. Then, we analyze equity in hospital accessibility using the Lorenz curve and Gini index model and compare the spatial and social equity values at the city and regional level. The results show that, after accounting for edge effects, the equality of hospital accessibility in the edge city improved. The edge effects significantly influenced the spatial and social equity in hospital accessibility in the edge city.From a spatial perspective, the edge effects vary by neighborhood location, type of hospital, and transit mode. The equity values for higher-tier hospital accessibility by vehicle-based travel modes are impacted by edge effects. From a social perspective, considering edge effects would represent the actual social equity among different income groups. Specifically, including accessibility to hospitals in the metropolis reduces under estimation of accessibility to healthcare resources by the vehicle for middle class groups. Our findings offer helpful insights for healthcare equity researchers interested in edge cities and the influence of edge effects on equity in accessing hospitals.