IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2020i1p112-d468641.html
   My bibliography  Save this article

Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China

Author

Listed:
  • Kan Wang

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

  • Jianjun Bai

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

  • Xing Dang

    (School of Geography and Tourism, Shaanxi Normal University, Xi’an 710119, China)

Abstract

The contradiction between the supply and demand of public medical resources in China is serious. On the basis of the “graded diagnosis and treatment” model, the Chinese government divides the medical grade and adjusts the allocation of medical facilities so as to alleviate the adverse impact of these issues on residents’ health. Although the government tries to guide residents’ medical treatment according to the level of medical facilities, there are differences between residents’ medical treatment mode and policy rules in reality. Therefore, it is of great significance to explore spatial differences in accessibility to medical services for residents on the basis of the actual medical behavior. This article takes Shaanxi province as the research area, and uses the improved node cost network analysis method with the space-time distance model and the two-step floating catchment area method, respectively, to analyze the spatial differences of accessibility to three-level medical services and evaluate the equity of accessibility in different areas and groups in Shaanxi. Results showed that the overall level of accessibility to primary medical services in the province is good, and spatial distribution is balanced; the polarization of accessibility to secondary and tertiary medical services is a serious issue, and within the research area, a band-shaped multicore spatial structure was formed with the built-up areas of various cities as high-level centers of accessibility. Provincial residents have poor equity to access three-level medical services, and the equity of accessibility to primary medical services is better than that to highly specialized medical services. There is no obvious gap between accessibility to three-level medical services for the aging and the nonaging populations in Shaanxi, but the unfair phenomenon between agricultural and the nonagricultural populations is prominent. In addition, this article found that the improvement in traffic conditions can produce space-time convergence and effectively weaken spatial deprivation. Therefore, developing public transportation is an effective approach to improve the equity of accessibility to medical services.

Suggested Citation

  • Kan Wang & Jianjun Bai & Xing Dang, 2020. "Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China," IJERPH, MDPI, vol. 18(1), pages 1-20, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2020:i:1:p:112-:d:468641
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/1/112/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/1/112/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Pan, Jay & Zhao, Hanqing & Wang, Xiuli & Shi, Xun, 2016. "Assessing spatial access to public and private hospitals in Sichuan, China: The influence of the private sector on the healthcare geography in China," Social Science & Medicine, Elsevier, vol. 170(C), pages 35-45.
    2. Guzman, Luis A. & Oviedo, Daniel & Rivera, Carlos, 2017. "Assessing equity in transport accessibility to work and study: The Bogotá region," Journal of Transport Geography, Elsevier, vol. 58(C), pages 236-246.
    3. Liu, Liwen & Zhang, Ming, 2018. "High-speed rail impacts on travel times, accessibility, and economic productivity: A benchmarking analysis in city-cluster regions of China," Journal of Transport Geography, Elsevier, vol. 73(C), pages 25-40.
    4. Wei Hu & Lin Li & Mo Su, 2019. "Spatial Inequity of Multi-Level Healthcare Services in a Rapid Expanding Immigrant City of China: A Case Study of Shenzhen," IJERPH, MDPI, vol. 16(18), pages 1-16, September.
    5. Kelobonye, Keone & McCarney, Gary & Xia, Jianhong (Cecilia) & Swapan, Mohammad Shahidul Hasan & Mao, Feng & Zhou, Heng, 2019. "Relative accessibility analysis for key land uses: A spatial equity perspective," Journal of Transport Geography, Elsevier, vol. 75(C), pages 82-93.
    6. Gerardo Carpentieri & Carmen Guida & Houshmand E. Masoumi, 2020. "Multimodal Accessibility to Primary Health Services for the Elderly: A Case Study of Naples, Italy," Sustainability, MDPI, vol. 12(3), pages 1-15, January.
    7. Tianlu Qian & Jie Chen & Ang Li & Jiechen Wang & Dingtao Shen, 2020. "Evaluating Spatial Accessibility to General Hospitals with Navigation and Social Media Location Data: A Case Study in Nanjing," IJERPH, MDPI, vol. 17(8), pages 1-16, April.
    8. Delbosc, Alexa & Currie, Graham, 2011. "Using Lorenz curves to assess public transport equity," Journal of Transport Geography, Elsevier, vol. 19(6), pages 1252-1259.
    9. Karen Lucas & Bert Wee & Kees Maat, 2016. "A method to evaluate equitable accessibility: combining ethical theories and accessibility-based approaches," Transportation, Springer, vol. 43(3), pages 473-490, May.
    10. Wei Chiang Chan & Wan Hashim Wan Ibrahim & May Chiun Lo & Mohamad Kadim Suaidi & Shiaw Tong Ha, 2020. "Sustainability of Public Transportation: An Examination of User Behavior to Real-Time GPS Tracking Application," Sustainability, MDPI, vol. 12(22), pages 1-20, November.
    11. Zhicheng Zheng & Haoming Xia & Shrinidhi Ambinakudige & Yaochen Qin & Yang Li & Zhixiang Xie & Lijun Zhang & Haibin Gu, 2019. "Spatial Accessibility to Hospitals Based on Web Mapping API: An Empirical Study in Kaifeng, China," Sustainability, MDPI, vol. 11(4), pages 1-14, February.
    12. Sunwei Liu & Yupeng Wang & Dian Zhou & Yitong Kang, 2020. "Two-Step Floating Catchment Area Model-Based Evaluation of Community Care Facilities’ Spatial Accessibility in Xi’an, China," IJERPH, MDPI, vol. 17(14), pages 1-17, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Huanhuan Zhu & Lin Pan & Yiji Li & Huiming Jin & Qian Wang & Xin Liu & Cong Wang & Peng Liao & Xinyang Jiang & Luo Li, 2021. "Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China," IJERPH, MDPI, vol. 18(19), pages 1-17, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gabriella Vitorino Guimarães & Tálita Floriano Santos & Vicente Aprigliano Fernandes & Jorge Eliécer Córdoba Maquilón & Marcelino Aurélio Vieira da Silva, 2020. "Assessment for the Social Sustainability and Equity under the Perspective of Accessibility to Jobs," Sustainability, MDPI, vol. 12(23), pages 1-23, December.
    2. Ji, Wei & Huang, Zhengfeng & Gao, Gao & Zheng, Pengjun, 2024. "Evaluation of integrated transport efficiency and equity at the county level——taking the counties in ningbo city as an example," Transport Policy, Elsevier, vol. 148(C), pages 257-272.
    3. Chen, Zhiwei & Guo, Yujie & Stuart, Amy L. & Zhang, Yu & Li, Xiaopeng, 2019. "Exploring the equity performance of bike-sharing systems with disaggregated data: A story of southern Tampa," Transportation Research Part A: Policy and Practice, Elsevier, vol. 130(C), pages 529-545.
    4. Gu, Zongni & Luo, Xiaolong & Tang, Mi & Liu, Xiaoman, 2023. "Does the edge effect impact the healthcare equity? An examination of the equity in hospitals accessibility in the edge city in multi-scale," Journal of Transport Geography, Elsevier, vol. 106(C).
    5. Zhu, Le & Shi, Fei, 2022. "Spatial and social inequalities of job accessibility in Kunshan city, China: Application of the Amap API and mobile phone signaling data," Journal of Transport Geography, Elsevier, vol. 104(C).
    6. Jun Yang & Andong Guo & Xueming Li & Tai Huang, 2018. "Study of the Impact of a High-Speed Railway Opening on China’s Accessibility Pattern and Spatial Equality," Sustainability, MDPI, vol. 10(8), pages 1-13, August.
    7. Luis A. Guzman & Daniel Oviedo & Rafael Cardona, 2018. "Accessibility Changes: Analysis of the Integrated Public Transport System of Bogotá," Sustainability, MDPI, vol. 10(11), pages 1-15, October.
    8. Hugo de Alba-Martínez & Alejandro L. Grindlay & Gabriela Ochoa-Covarrubias, 2020. "(In)Equitable Accessibility to Sustainable Transport from Universities in the Guadalajara Metropolitan Area, Mexico," Sustainability, MDPI, vol. 13(1), pages 1-18, December.
    9. de Oliveira Souza, Camilla & Vitorino Guimarães, Gabriella & da Cruz Saldanha, Luiz Emerson & Almeida Corrêa do Nascimento, Filipe & Floriano dos Santos, Tálita & Vieira da Silva, Marcelino Aurélio, 2021. "Analysis of job accessibility promoted by ride hailing services: A proposed method," Journal of Transport Geography, Elsevier, vol. 93(C).
    10. Zongni Gu & Xiaolong Luo & Yanru Chen & Xiaoman Liu & Chenrui Xiao & Yifan Liang, 2022. "Density, Diversity, and Design: Evaluating the Equity of the Elderly Communities in Three Measures of the Built Environment," Land, MDPI, vol. 11(11), pages 1-17, November.
    11. Ben-Elia, Eran & Benenson, Itzhak, 2019. "A spatially-explicit method for analyzing the equity of transit commuters' accessibility," Transportation Research Part A: Policy and Practice, Elsevier, vol. 120(C), pages 31-42.
    12. Deboosere, Robbin & El-Geneidy, Ahmed, 2018. "Evaluating equity and accessibility to jobs by public transport across Canada," Journal of Transport Geography, Elsevier, vol. 73(C), pages 54-63.
    13. Jin, Tanhua & Cheng, Long & Wang, Kailai & Cao, Jun & Huang, Haosheng & Witlox, Frank, 2022. "Examining equity in accessibility to multi-tier healthcare services across different income households using estimated travel time," Transport Policy, Elsevier, vol. 121(C), pages 1-13.
    14. Chih-Hao Wang & Na Chen, 2021. "A multi-objective optimization approach to balancing economic efficiency and equity in accessibility to multi-use paths," Transportation, Springer, vol. 48(4), pages 1967-1986, August.
    15. Boisjoly, Geneviève & Serra, Bernardo & Oliveira, Gabriel T. & El-Geneidy, Ahmed, 2020. "Accessibility measurements in São Paulo, Rio de Janeiro, Curitiba and Recife, Brazil," Journal of Transport Geography, Elsevier, vol. 82(C).
    16. Shang, Qingxue & Guo, Xiaodong & Li, Jichao & Wang, Tao, 2022. "Post-earthquake health care service accessibility assessment framework and its application in a medium-sized city," Reliability Engineering and System Safety, Elsevier, vol. 228(C).
    17. Lin, Joanne Yuh-Jye & Jenelius, Erik & Cebecauer, Matej & Rubensson, Isak & Chen, Cynthia, 2023. "The equity of public transport crowding exposure," Journal of Transport Geography, Elsevier, vol. 110(C).
    18. Chen, Zhiwei & Li, Xiaopeng, 2021. "Unobserved heterogeneity in transportation equity analysis: Evidence from a bike-sharing system in southern Tampa," Journal of Transport Geography, Elsevier, vol. 91(C).
    19. , Marcin Wozniak & Radzimski, Adam & Wajchman-Świtalska, Sandra, 2024. "Is More Always Better? Evaluating Accessibility to Parks and Forests in 33 European Cities Using Sustainable Modes of Transportation," OSF Preprints hcwgp, Center for Open Science.
    20. Xia, Jianhong(Cecilia) & Nesbitt, Joshua & Daley, Rebekah & Najnin, Arfanara & Litman, Todd & Tiwari, Surya Prasad, 2016. "A multi-dimensional view of transport-related social exclusion: A comparative study of Greater Perth and Sydney," Transportation Research Part A: Policy and Practice, Elsevier, vol. 94(C), pages 205-221.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2020:i:1:p:112-:d:468641. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.