Abstract
Amidst the spectrum of medical facilities, community health service centers (CHSCs) play an important role in alleviating the burden on hospitals. However, the intricate interaction between hospitals and CHSCs in accessibility analysis is often overlooked. To fill this gap, this study employs an enhanced gravity model to evaluate spatial accessibility of hospitals, focusing on both subdistrict and CHSC levels. The findings show that tertiary hospitals, providing the highest quality medical services, are concentrated in the central districts of Nanjing. Moreover, prevailing CHSC deployment plans risk an inequitable allocation of medical resources at the subdistrict level. In response, we proposed a collaborative mechanism that synergizing hospitals and CHSCs, built on a reciprocal medical alliance referral system. Specifically, our recommendations include: (1) promoting CHSCs to engage in alleviating the patient treatment load borne by tertiary hospitals in the central districts; and (2) balancing between the quality and quantity of CHSCs in the peripheral districts to increase accessibility for small-sized CHSCs in remote locations. This study contributes to the existing literature by incorporating CHSCs into hospital accessibility analysis and refining the framework for the spatial distribution of medical facility in alignment with established policies.
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Data Availability
Data are available at the following location: https://docs.google.com/spreadsheets/d/1RUqBE1QUP1ruOEE807TeYhkz7snip4FE/edit?usp=drive_link&ouid=110747871300533132233&rtpof=true&sd=true, https://docs.google.com/spreadsheets/d/1RUqBE1QUP1ruOEE807TeYhkz7snip4FE/edit?usp=drive_link&ouid=110747871300533132233&rtpof=true&sd=true.
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Acknowledgements
This paper is funded by the Shanghai Nature and Health Foundation (Grant No. 20230701 SNHF), Shanghai, China; NYU Shanghai Major-Grants Seed Fund (Grant No. 2022_MGSF); Pudong Pearl Program Leading Scheme 2023, Pudong Talents Office; Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning (Grant No. 20230111 SMEC); National Foreign Young Talents Program from the State Administration of Foreign Experts Affairs (Grant No. 10109_ Special Grant). We received support from the PEAK Urban Programme at University of Oxford, which is funded by UKRI’s Global Challenge Research Fund (Grant Ref: ES/P011055/1).
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Cai, Z., Cheng, T., Li, Y. et al. Spatial Analysis of Hospital Accessibility in Nanjing: The Role of Community Health Service Centers. Appl. Spatial Analysis (2024). https://doi.org/10.1007/s12061-024-09577-8
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DOI: https://doi.org/10.1007/s12061-024-09577-8