Spatial Accessibility
2023-7-17
Hierarchical two-step floating catchment area (2SFCA) method: measuring the spatial accessibility to hierarchical healthcare facilities in Shenzhen, China
This paper proposed a Hierarchical Two-Step Floating Catchment Area method to measure spatial accessibility to hierarchical healthcare facilities, accounting for their varied catchment sizes, distance decay effects, transport modes, and incorporating absolute distance effects, then applied it to facilities in Shenzhen, China.
Abstract:
Background: Spatial accessibility to healthcare facilities has drawn much attention in health geography. In China, central and local governments have aimed to develop a well-organized hierarchical system of healthcare facilities in recent years. However, few studies have focused on the measurement of healthcare accessibility in a hierarchical service delivery system, which is crucial for the assessment and implementation of such strategies.
Methods: Based on recent improvements in 2SFCA (two-step floating catchment area) method, this study aims to propose a Hierarchical 2SFCA (H2SFCA) method for measuring spatial accessibility to hierarchical facilities. The method considers the varied catchment area sizes, distance decay effects, and transport modes for facilities at various levels. Moreover, both the relative and absolute distance effects are incorporated into the accessibility measurement.
Results: The method is applied and tested in a case study of hierarchical healthcare facilities in Shenzhen, China. The results reveal that the general spatial accessibility to hierarchical healthcare facilities in Shenzhen is unevenly distributed and concentrated. The disparity of general accessibility is largely caused by the concentrated distribution of tertiary hospitals. For facilities at higher levels, average accessibility of demanders is higher, but there are also larger disparities in spatial accessibility. The comparison between H2SFCA and traditional methods reveals that traditional methods underestimate the spatial disparity of accessibility, which may lead to biased suggestions for policy making.
Conclusions: The results suggest that the supply of healthcare resources at primary facilities is far from sufficient. To improve the spatial equity in spatial accessibility to hierarchical healthcare facilities, various actions are needed at different levels. The proposed H2SFCA method contributes to the modelling of spatial accessibility to hierarchical healthcare facilities in China and similar environments where the referral system has not been well designed. It can also act as the foundation for developing more comprehensive measures in future studies.
Summary:
- Proposes Hierarchical Two-Step Floating Catchment Area (H2SFCA) method to measure accessibility to hierarchical facilities
- Accounts for varied catchment sizes, distance decay effects, transport modes for different facility levels
- Incorporates both relative and absolute distance effects into accessibility measurement
- Applies method to hierarchical healthcare facilities in Shenzhen, China
- Finds general spatial accessibility is uneven, concentrated in central districts
- Accessibility higher but more disparate at higher facility levels
- Disparity largely caused by concentrated distribution of tertiary hospitals
- Compared to traditional methods, H2SFCA better captures disparity in accessibility
Study questions and answers:
| Study Questions | Answers |
|---|---|
| What is the proposed method? | Hierarchical Two-Step Floating Catchment Area (H2SFCA) |
| What characteristics of hierarchical facilities does it account for? | Varied catchment sizes, distance decay effects, transport modes by level |
| What additional distance effect does it incorporate? | Absolute distance effect |
| Where was the method applied? | Hierarchical healthcare facilities in Shenzhen, China |
| How did accessibility vary by facility level? | Higher but more disparate at higher levels |
| What mainly caused the disparity in general accessibility? | Concentrated distribution of tertiary hospitals |