Abstract
Current studies on measuring the accessibility of medical services for the elderly (AMSE) have ignored the potential competition among supply and demand and the distance decay laws. Hence, an enhanced two-step floating catchment area (E2SFCA) method (i.e., the road network-based Gaussian 2SFCA method) is proposed to calculate AMSE scores after considering different types of roads, including urban rail transit, freeways, major roads, minor roads and rural roads. Based on the first National Geographic Conditions Monitoring (NGCM) data, this study took Wuhan, China, as a case study and assessed the variation of AMSE using two different threshold times (i.e., Platinum Ten and Golden Hour). Next, global (i.e., sensitivity and hot spot analysis) and local analyses (i.e., three regional area internal comparisons) of AMSE scores were conducted to accurately identify details in the variation of spatial accessibility. It was observed that the E2SFCA method could be easily applied to measure AMSE. The results showed that 48.63% of the elderly population in Wuhan had a higher or the highest level of medical accessibility in “Platinum Ten”, while 72.97% had a higher or the highest level in the “Golden Hour”, and hot spots of AMSE scores were located in central urban areas and presented an enclosure structure using both threshold travel times, which could provide guidance to governments or planners on issues of spatial planning and identifying elderly medical services shortage areas.
Highlights
The world population continues to age rapidly, as fertility rates have fallen to very low levels in many countries, and people tend to live longer [1]
The results showed that hot spots were located in the central urban areas, and the spatial pattern of accessibility of medical services for the elderly (AMSE) scores in Wuhan city presented an enclosure structure in general
The results showed that hot spots were located in the urban areas, and the spatial pattern of AMSE scores in Wuhan city presented an enclosure structure central urban areas, and the spatial pattern of AMSE scores in Wuhan city presented an enclosure in general
Summary
The world population continues to age rapidly, as fertility rates have fallen to very low levels in many countries, and people tend to live longer [1]. The trend towards older populations is largely irreversible [2]. The report An Ageing World: 2015, released by the U.S Census Bureau in 2016, stated that 8.5% of the worldwide population was aged ≥65 years in 2015 and has reached 617 million, and this proportion is expected to almost double by 2050 [3]. An ageing population has significant, dynamic and complex healthcare needs [4]. The elderly, as a vulnerable population, need more accessible medical services. In 2002, the World Health Organization (WHO) released Active Ageing:
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