Inequalities of spatial primary healthcare accessibility in China

北京 地理 中国 不平等 集水区 中国大陆 人口 人口普查 医疗保健 地理编码 社会经济学 流域 区域科学 地图学 经济增长 环境卫生 医学 社会学 数学分析 经济 考古 数学
作者
Peng Jia,Youfa Wang,Min Yang,Limin Wang,Zutao Ouyang,Xinyu Shi,Lijian Yang,Jin Wen,Yi Liu,Maokang Yang,Junguo Xin,Fengying Zhang,Lihua Jiang,Chunhua Chi,Luxia Zhang,Xudong Ma,Xiao Ma,Li Zhao,Weimin Li
出处
期刊:Social Science & Medicine [Elsevier BV]
卷期号:314: 115458-115458 被引量:31
标识
DOI:10.1016/j.socscimed.2022.115458
摘要

A key step to the establishment of a tiered healthcare system is equitable access to basic primary healthcare services for all. However, no quantitative research on the national status quo of primary healthcare accessibility in China exists. We filled this gap by estimating spatial accessibility to primary healthcare centers (PHCs) and mapping its inequality across the mainland China. Four national datasets during 2015-2018, including administrative boundaries, residential communities, points-of-interest (including PHCs), and road networks, were collected to calculate the distance to the nearest PHC for each community. Five other national datasets including census, elevation, land use, vegetation, and nightlight, were collected to model 100m × 100 m population grids, based on which geographical modeling was used to calculate PHC accessibility of each community. Inequalities in PHC accessibility across China were described with concentration indices. About 44% of communities across China representing approximately 30% of the overall population had no access to PHCs within their 6-km catchment areas; about 78% of communities across China representing approximately 68.4% of the overall population had no access to PHCs within their 1.5-km catchment areas. Some municipalities/provinces like Shanghai, Beijing, Tianjin, Jiangsu, Shandong, and Zhejiang generally had higher proximity to the nearest PHCs, while others like Tibet, Guizhou, and Guangxi had lower proximity to the nearest PHCs. However, assuming similar basic service capacity across all PHCs, Shanghai, Tianjin, and Chongqing showed the lowest PHC accessibility due to high population density. Variations in PHC accessibility existed, with more inequalities observed in the north and northeastern provinces and less inequalities in southwestern and south-central provinces. This study demonstrates primary healthcare accessibility and inequality at province and city levels, and identifies communities with lower proximity and accessibility to PHCs in China. It would serve as a starting point to facilitate precise healthcare planning and preparedness for health emergencies in China.
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