标题: Inequalities of spatial primary healthcare accessibility in China

作者: Jia, P (Jia, Peng); Wang, YF (Wang, Youfa); Yang, M (Yang, Min); Wang, LM (Wang, Limin); Yang, XC (Yang, Xuchao); Shi, XY (Shi, Xinyu); Yang, LJ (Yang, Lijian); Wen, J (Wen, Jin); Liu, Y (Liu, Yi); Yang, MK (Yang, Maokang); Xin, JG (Xin, Junguo); Zhang, FY (Zhang, Fengying); Jiang, LH (Jiang, Lihua); Chi, CH (Chi, Chunhua); Zhang, LX (Zhang, Luxia); Ma, XD (Ma, Xudong); Ma, X (Ma, Xiao); Zhao, L (Zhao, Li); Li, WM (Li, Weimin)

来源出版物: SOCIAL SCIENCE & MEDICINE 卷: 314 文献号: 115458 DOI: 10.1016/j.socscimed.2022.115458 出版年: DEC 2022

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 x 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.

作者关键词: Primary healthcare; Community healthcare; Spatial accessibility; Inequality; Population modeling; China

地址: [Jia, Peng] Wuhan Univ, Sch Resource & Environm Sci, Wuhan, Hubei, Peoples R China.

[Jia, Peng] Wuhan Univ, Sch Publ Hlth, Wuhan, Hubei, Peoples R China.

[Wang, Youfa] Xi An Jiao Tong Univ, Sch Publ Hlth, Global Hlth Inst, Hlth Sci Ctr, Xian, Shaanxi, Peoples R China.

[Yang, Min; Liu, Yi; Zhao, Li] Sichuan Univ, West China Sch Publ Hlth, Dept Hlth Policy & Management, Chengdu, Sichuan, Peoples R China.

[Yang, Min; Liu, Yi; Jiang, Lihua; Ma, Xiao; Zhao, Li] Sichuan Univ, West China Hosp 4, Chengdu, Sichuan, Peoples R China.

[Wang, Limin] Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China.

[Yang, Xuchao] Zhejiang Univ, Ocean Coll, Zhoushan, Zhejiang, Peoples R China.

[Shi, Xinyu] Univ Twente, Univ Coll Twente, Enschede, Netherlands.

[Yang, Lijian] Tsinghua Univ, Ctr Stat Sci, Beijing, Peoples R China.

[Wen, Jin; Li, Weimin] Sichuan Univ, West China Hosp, Inst Hosp Management, Chengdu, Sichuan, Peoples R China.

[Yang, Maokang] Sichuan Hosp Assoc, Div Rural Hlth, Chengdu, Sichuan, Peoples R China.

[Xin, Junguo] Chengdu Med Coll, Sch Publ Hlth, Chengdu, Sichuan, Peoples R China.

[Jiang, Lihua; Ma, Xiao] Sichuan Univ, West China Sch Publ Hlth, Dept Hlth Related Social & Behav Sci, Chengdu, Sichuan, Peoples R China.

[Zhang, Fengying] Sichuan Univ, West China Sch Nursing, West China Hosp, Chengdu, Sichuan, Peoples R China.

[Chi, Chunhua] Peking Univ, Dept Gen Practice, Hlth Sci Ctr, Beijing, Peoples R China.

[Chi, Chunhua] Peking Univ First Hosp, Hlth Management Ctr, Beijing, Peoples R China.

[Zhang, Luxia] Peking Univ, Natl Inst Hlth Data Sci, Beijing, Peoples R China.

[Zhang, Luxia] Peking Univ First Hosp, Dept Med, Renal Div, Beijing, Peoples R China.

[Ma, Xudong] Beijing China, Natl Hlth Commiss Peoples Republ China, Bur Med Adm, Beijing, Peoples R China.

[Jia, Peng] Wuhan Univ, Int Inst Spatial Lifecourse Hlth ISLE, Wuhan, Hubei, Peoples R China.

通讯作者地址: Jia, P (通讯作者)，Wuhan Univ, Sch Resource & Environm Sci, Wuhan, Hubei, Peoples R China.

Ma, X; Zhao, L (通讯作者)，Sichuan Univ, West China Hosp 4, Chengdu, Sichuan, Peoples R China.

Ma, XD (通讯作者)，Natl Hlth Commiss Peoples Republ China, Beijing, Peoples R China.

Ma, X; Zhao, L (通讯作者)，Sichuan Univ, West China Sch Publ Hlth, Chengdu, Sichuan, Peoples R China.

Li, WM (通讯作者)，Sichuan Univ, West China Hosp, Chengdu, Sichuan, Peoples R China.

影响因子：5.379