From service capacity to spatial equity: Exploring a multi-stage decision-making approach for optimizing elderly-care facility distribution in the city centre of Tianjin, China

Abstract

• A decision-making approach for optimizing elderly-care facilities distribution is proposed. • A multi-stage measure procedure from service capacity to spatial equity is further devised. • The methodology is implemented in six districts in central Tianjin to demonstrate its applicability. • The spatial equity for each facility category in the six districts was evaluated and compared quantitatively. • Based on 24/7 nursing homes distribution, targeted optimisation suggestions are proposed in inequitable areas. With the unprecedented growth of the ageing population and the insufficiency of social services, the equitable distribution of elderly-care facilities (ECFs) according to demand of older adults has become a major concern of existing communities in the city centre with limited land use and high population density. To address the issue of social sustainability, this study explores a decision-making approach for measuring spatial equity. The distribution of three categories of ECFs in Tianjin city was examined by integrating the analysis of the current situation, accessibility, Lorenz curve and Gini coefficient, and spatial autocorrelation. In addition, spatial distribution status and potential accessibility were extracted and mapped to illustrate the service capacity. Subsequently, considering the population distribution, spatial equity was evaluated, and areas in supply-demand imbalance were identified. The results showed that 60% of the elderly shared only 25% of the elderly-care services, indicating a widespread inequity among districts and facilities. Interestingly, service capacity and spatial equity rankings varied for 24/7 nursing homes, while day-care centres and assisted-dining facilities remained consistent. This study would help urban planners assess and locate areas of spatial inequity and provide insight into the decision-making approaches adopted at different stages with the aim of sustainable development.