Abstract:
With the unprecedented growth of the elderly population in China, elderly-care facilities (ECFs) are in a fast expansion process. However, limited attention has been paid to the imbalance at the actual utilization level of ECFs. This research aims to reveal the spatial inequity of ECFs and to quantitatively examine the effect of accessibility and institutional service capacity on utilization. Taking Chongqing, China, as the study area, we measured the spatial accessibility of different travel modes by the Gaussian Two-Step Floating Catchment Area (G2SFCA) method and investigated distribution differences in spatial accessibility, service capacity, and utilization of ECFs by the Dagum Gini Coefficient and its decomposition. Then, the impact of spatial accessibility and service capacity on the utilization of regional ECFs was quantified by multiscale geographically weighted regression (MGWR). The study findings can be summarized as follows. (1) Walking accessibility has the most significant impact on the utilization of ECFs and shows geographic heterogeneity. Developing a pedestrian-oriented network of pathways is essential to enhance the utilization of ECFs. (2) Accessibility by driving and bus-riding does not correlate with regional ECFs utilization, and relevant studies cannot rely on them alone for assessing the equity of ECFs. (3) In the utilization of ECFs, since the inter-regional difference is more significant than the intra-regional difference, efforts to reduce the overall imbalance should be oriented toward inter-regional variation. The study’s findings will assist national policymakers in developing EFCs to enhance health indicators and quality of life for older adults by prioritizing financing for shortage areas, coordinating ECFs services, and optimizing road systems.
Summary:
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The study examines the utilization of elderly care facilities (ECFs) in Chongqing, China.
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Spatial accessibility and service capacity were measured for ECFs. Accessibility was calculated using the Gaussian Two-Step Floating Catchment Area method.
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Walking accessibility had the most significant impact on ECF utilization, with spatial heterogeneity in this impact.
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Accessibility by rail transit and service capacity also affected ECF utilization, but less so than walking accessibility.
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Inter-regional differences contributed more to overall inequity in ECF utilization than intra-regional differences.
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Driving and bus accessibility did not correlate with ECF utilization, so should be carefully considered in equity assessments.
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Improving pedestrian infrastructure is critical to enhance ECF utilization. Reducing inter-regional variation is key to overall equity.
Study questions and answers:
| Study Questions | Answers |
|---|
| What was the study location and topic? | Chongqing, China; equity of elderly care facilities |
| How was spatial accessibility measured? | Gaussian Two-Step Floating Catchment Area method |
| What mode had the greatest impact? | Walking accessibility |
| What other factors affected utilization? | Rail transit accessibility, service capacity |
| What caused more overall inequity? | Inter-regional differences |
| What modes did not affect utilization? | Driving and bus accessibility |
| How can utilization be improved? | Enhance pedestrian infrastructure, reduce inter-regional variation |