Equity Evaluation of Multilevel Medical Facility Allocation Based on Ga2SFCA

Abstract

Equity in the distribution of medical facilities is critical to the effectiveness of healthcare investments and the equality of residents’ right to health. In recent years, the Chinese Government has been working to establish a well-organized hierarchical system of medical facilities. However, few studies have focused on the evaluation of multilevel medical facility accessibility and equity, and they are usually based on a single urban road network without considering the distinction between walkways and carriageways. To address these issues, this study analyzed and calculated results on the distribution of multilevel medical facilities in terms of accessibility and equity evaluation based on a Gaussian two-step floating catchment area method, an improved medical facility supply capacity model, and two road networks of walkways and carriageways in the central urban area of Jinan, China. The results showed that the distribution of medical facilities shows the vacuum phenomenon of primary medical facilities and the polarization phenomenon of tertiary medical facilities and that the shortage of accessibility of primary medical facilities is masked when comprehensive accessibility calculations are performed. The results of the Gini coefficient and Lorenz curve showed that the distribution of primary medical facilities is extremely inequitable and that increasing the number of primary medical facilities and their supply capacity remains a priority for China to promote health equity. The results of the aforementioned study suggested strategies for medical facility system improvement and urban road network planning: planning new primary hospitals in densely populated areas, building large general hospitals in the eastern and western edges of the city, building east–west road networks to increase road centerline density, and so on. The improved Gaussian two-step floating catchment area method (Ga2SFCA) helps to construct a spatial accessibility model for multilevel medical facilities, and the adopted methods of accessibility and equity analysis are also useful for siting studies on the layout of other service facilities such as education and elderly care.