Planning Strategies for Promoting Spatial Accessibility of Healthcare Facilities in Shrinking Cities: A Case Study of Lufeng in China

Rational allocation of healthcare facilities is a key component of planning strategies in promoting public health and wellbeing worldwide. Many Chinese cities have been experiencing population loss, making it challenging to match the supply and demand of healthcare facilities accurately. How to plan healthcare facilities to improve spatial accessibility in shrinking cities is still an underresearched topic. Taking Lufeng in China as the case, we used residential electricity consumption rate as proxy data to rectify the actual population distribution and used Gaussian two-step floating catchment area (G2SFCA) to evaluate the spatial accessibility of hierarchical healthcare facilities for making recommendations to improve the planning of healthcare facilities in shrinking cities to achieve better spatial accessibility. Our findings indicated that: (1) the supply and demand of healthcare facilities were generally not well matched, especially in the fringe area; (2) the sudden influx population during festival periods placed additional burden on medical resources in the fringe area and its spatial accessibility, especially on township hospitals and community healthcare services; and (3) to promote the spatial accessibility of healthcare facilities in shrinking cities, we proposed related planning strategies regarding the targeted allocation of three-level healthcare facilities to match the hierarchical diagnosis and treatment, and flexible setting of mobile healthcare facilities and telemedicine to echo the temporal population changes. These findings can provide references for improving livelihood health in cities experiencing population loss.