IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i5p3017-d764345.html
   My bibliography  Save this article

Evaluations of Spatial Accessibility and Equity of Multi-Tiered Medical System: A Case Study of Shenzhen, China

Author

Listed:
  • Meng Tian

    (Lab for Optimizing Design of Built Environment, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China)

  • Lei Yuan

    (Lab for Optimizing Design of Built Environment, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China)

  • Renzhong Guo

    (Research Institute for Smart Cities, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518060, China
    Guangdong Key Laboratory of Urban Informatics, Shenzhen University, Shenzhen 518060, China
    MNR Technology Innovation Centre of Territorial & Spatial Big Data, Shenzhen University, Shenzhen 518060, China)

  • Yongsheng Wu

    (Shenzhen Centre for Disease Control and Prevention, Shenzhen 518055, China)

  • Xiaojian Liu

    (Shenzhen Centre for Disease Control and Prevention, Shenzhen 518055, China)

Abstract

The Chinese government has implemented a medical system reform to improve the equity of healthcare resources since 2009. We selected Shenzhen as our study area and evaluated the accessibility and equity of the multi-tiered medical system in China using a novel multi-tiered two-step floating catchment area (MT2SFCA) method. We proposed the benchmark and applied the independent variables of travel time and facility attractiveness, along with a combination of the two factors, as tolerances to determine the new logistic cumulative distribution decay functions. Community health centers (CHCs) and hospitals were included while integrating their features. Results revealed that the MT2SFCA method was able to determine the particular advantages of CHCs and hospitals in the multi-tiered medical system. The CHCs offset the lower accessibility of hospitals in suburban areas and hospitals balanced the regional inequity caused by the CHC. Travel time is the main consideration of patients who have access to CHCs, whereas facility features are the main considerations of patients who have access to hospitals. Notably, both CHCs and hospitals are crucial for the whole multi-tiered medical system. Finally, we suggested modifications in different travel modes, weights of contributing factors, and the validation of decay functions to improve the MT2SFCA method.

Suggested Citation

  • Meng Tian & Lei Yuan & Renzhong Guo & Yongsheng Wu & Xiaojian Liu, 2022. "Evaluations of Spatial Accessibility and Equity of Multi-Tiered Medical System: A Case Study of Shenzhen, China," IJERPH, MDPI, vol. 19(5), pages 1-18, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:3017-:d:764345
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/5/3017/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/5/3017/
    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. Sinha, Antika & Chakrabarti, Bikas K., 2019. "Inequality in death from social conflicts: A Gini & Kolkata indices-based study," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 527(C).
    3. Dahlgren, Cecilia & Dackehag, Margareta & Wändell, Per & Rehnberg, Clas, 2021. "Simply the best? The impact of quality on choice of primary healthcare provider in Sweden," Health Policy, Elsevier, vol. 125(11), pages 1448-1454.
    4. Bowles, Samuel & Carlin, Wendy, 2020. "Inequality as experienced difference: A reformulation of the Gini coefficient," Economics Letters, Elsevier, vol. 186(C).
    5. Jomehpour Chahar Aman, Javad & Smith-Colin, Janille, 2020. "Transit Deserts: Equity analysis of public transit accessibility," Journal of Transport Geography, Elsevier, vol. 89(C).
    6. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    7. Jan Bauer & David A Groneberg, 2016. "Measuring Spatial Accessibility of Health Care Providers – Introduction of a Variable Distance Decay Function within the Floating Catchment Area (FCA) Method," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-17, July.
    8. Chen, Qiulin & Xu, Duo & Fu, Hongqiao & Yip, Winnie, 2022. "Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China," China Economic Review, Elsevier, vol. 72(C).
    9. Jiang, Shan & Gu, Yuanyuan & Yang, Fan & Wu, Tao & Wang, Hui & Cutler, Henry & Zhang, Lufa, 2020. "Tertiary hospitals or community clinics? An enquiry into the factors affecting patients' choice for healthcare facilities in urban China," China Economic Review, Elsevier, vol. 63(C).
    10. Gonçalo Santinha & Jan Wolf & Catarina Costa, 2020. "Aging and the built environment: is mobility constrained for institutionalized older adults?," Journal of Urbanism: International Research on Placemaking and Urban Sustainability, Taylor & Francis Journals, vol. 13(4), pages 431-447, October.
    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. Yibin Ao & Qiqi Feng & Zhongli Zhou & Yunfeng Chen & Tong Wang, 2022. "Resource Allocation Equity in the China’s Rural Three-Tier Healthcare System," IJERPH, MDPI, vol. 19(11), pages 1-17, May.

    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. Tao, Zhuolin & Cheng, Yang & Du, Shishuai & Feng, Ling & Wang, Shaoshuai, 2020. "Accessibility to delivery care in Hubei Province, China," Social Science & Medicine, Elsevier, vol. 260(C).
    2. Shen, Chi & Lai, Sha & Deng, Qiwei & Cao, Dan & Zhao, Dantong & Zhao, Yaxin & Zhou, Zhongliang & Dong, Wanyue & Chen, Xi, 2023. "Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China," GLO Discussion Paper Series 1309, Global Labor Organization (GLO).
    3. Lapo Filistrucchi & Fatih Cemil Ozbugday, 2012. "Mandatory Quality Disclosure and Quality Supply: Evidence from German Hospitals," Working Papers - Economics wp2012_16.rdf, Universita' degli Studi di Firenze, Dipartimento di Scienze per l'Economia e l'Impresa.
    4. R. R. Croes & Y. J. F. M. Krabbe-Alkemade & M. C. Mikkers, 2018. "Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 5-19, January.
    5. Anne-Fleur Roos & Eddy van Doorslaer & Owen O'Donnell & Erik Schut & Marco Varkevisser, 2018. "Does price competition damage healthcare quality?," Tinbergen Institute Discussion Papers 18-040/V, Tinbergen Institute.
    6. Fangye Du & Jiaoe Wang & Haitao Jin, 2021. "Whether Public Hospital Reform Affects the Hospital Choices of Patients in Urban Areas: New Evidence from Smart Card Data," IJERPH, MDPI, vol. 18(15), pages 1-14, July.
    7. Fattahi, Mohammad & Keyvanshokooh, Esmaeil & Kannan, Devika & Govindan, Kannan, 2023. "Resource planning strategies for healthcare systems during a pandemic," European Journal of Operational Research, Elsevier, vol. 304(1), pages 192-206.
    8. Cho, Woohyun & Windle, Robert J. & Dresner, Martin E., 2017. "The impact of operational exposure and value-of-time on customer choice: Evidence from the airline industry," Transportation Research Part A: Policy and Practice, Elsevier, vol. 103(C), pages 455-471.
    9. Shi Bo & Chen Wen, 2018. "Individual Health Insurance Market with an Entrant – The ACA Health Insurance Exchange Observations," Asia-Pacific Journal of Risk and Insurance, De Gruyter, vol. 12(2), pages 1-27, July.
    10. Daniel Avdic & Tugba Bueyuekdurmus & Giuseppe Moscelli & Adam Pilny & Ieva Sriubaite, 2018. "Subjective and objective quality reporting and choice of hospital: Evidence from maternal care services in Germany," CINCH Working Paper Series 1803, Universitaet Duisburg-Essen, Competent in Competition and Health.
    11. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    12. Huotari, Tiina & Antikainen, Harri & Keistinen, Timo & Rusanen, Jarmo, 2017. "Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas," Social Science & Medicine, Elsevier, vol. 182(C), pages 60-67.
    13. Emmert, Martin & Schindler, Anja & Drach, Cordula & Sander, Uwe & Patzelt, Christiane & Stahmeyer, Jona & Kühnel, Elias & Lauerer, Michael & Nagel, Eckhard & Frömke, Cornelia & Schöffski, Oliver & Hep, 2022. "The use intention of hospital report cards among patients in the presence or absence of patient-reported outcomes," Health Policy, Elsevier, vol. 126(6), pages 541-548.
    14. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    15. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    16. Pilny, Adam & Mennicken, Roman, 2014. "Does Hospital Reputation Influence the Choice of Hospital?," Ruhr Economic Papers 516, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    17. Mennicken, Roman & Kolodziej, Ingo W.K. & Augurzky, Boris & Kreienberg, Rolf, 2014. "Concentration of gynaecology and obstetrics in Germany: Is comprehensive access at stake?," Health Policy, Elsevier, vol. 118(3), pages 396-406.
    18. Ruz, Soumendra Nath, 2023. "Amazing aspects of inequality indices (Gini and Kolkata Index) of COVID-19 confirmed cases in India," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 632(P2).
    19. Versteeg, S.E. & Ho, V.K.Y. & Siesling, S. & Varkevisser, M., 2018. "Centralisation of cancer surgery and the impact on patients’ travel burden," Health Policy, Elsevier, vol. 122(9), pages 1028-1034.
    20. Jing Luo & Guangping Chen & Chang Li & Bingyan Xia & Xuan Sun & Siyun Chen, 2018. "Use of an E2SFCA Method to Measure and Analyse Spatial Accessibility to Medical Services for Elderly People in Wuhan, China," IJERPH, MDPI, vol. 15(7), pages 1-17, July.

    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:19:y:2022:i:5:p:3017-:d:764345. 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.