https://doi.org/10.4081/gh.2021.995

Evaluating the accessibility to healthcare facilities under the Chinese hierarchical diagnosis and treatment system

Vol. 16 No. 2 (2021)
Submitted: 6 March 2021
Accepted: 4 May 2021
Published: 3 November 2021
Spatial accessibility, healthcare facilities, hierarchical diagnosis and treatment system, China.
Abstract Views: 1839
PDF: 750
HTML: 123
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Jingkai Yue
https://orcid.org/0000-0003-3614-9619
Logistics Department, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Qiang Fu
https://orcid.org/0000-0001-8259-8824
Department of Community Health, School of Arts and Sciences, Tufts University, Medford, MA, United States.
Ying Zhou
Human Resource Department, Wuhan Forth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yue Zhang
Department of Public Administration, Wuhan University of Science and Technology, Wuhan, China.
Jie Ning
Medical Insurance Office, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Gang Yin
Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hongbing Tao
hhbtao@hust.edu.cn
Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

An accurate assessment of current healthcare resource allocations is essential to address existing inequities in the hierarchical diagnosis and treatment system introduced in China. The data come from statistical reports of local governments and the developer platform of Amap, a Chinese mobile map. The data were analysed using the hierarchical two-step floating catchment area method. By spatial accessibility analysis, the distribution of accessibility to hierarchical healthcare facilities in Zhongshan City, Guangdong Province was found to be uneven, with clustered high accessibility in the central, north-western and southern parts of the city. To enhance the capacity of healthcare services, the government should allocate healthcare resources rationally to better associate with population densities.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Banister D, 1996. Transport and urban development. E & FN Spon, an imprint of Chapman & Hall, London, UK, pp. 28-30.
Bauer J, Groneberg DA, Maier W, Manek R, Louwen F, Brüggmann D, 2017. Accessibility of general and specialized obstetric care providers in Germany and England: an analysis of location and neonatal outcome. Int J Health Geogr 16:44. DOI: https://doi.org/10.1186/s12942-017-0116-6
Bagheri N, Benwell GL, Holt A, 2005. Measuring spatial accessibility to primary health care. Paper presented at the 17th Annual Colloquium of the Spatial Information Research Centre, University of Otago, New Zealand.
Central Committee of the Communist Party of China, 2020. Proposals for formulating the 14th Five-Year Plan (2021-2025) for National Economic and Social Development and the Long-Range Objectives Through the Year 2035. Available from: http://www.gov.cn/zhengce/2020-11/03/content_5556991.htm Accessed: 24 April 2021.
Cheng G, Zeng X, Duan L, Lu X, Sun H, Jiang T, 2016. Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen, China. Habitat Int 53:485-94. DOI: https://doi.org/10.1016/j.habitatint.2015.12.023
Delamater PL, 2013. Spatial accessibility in suboptimally configured health care systems: a modified two-step floating catchment area (M2SFCA) metric. Health Place 24:30-43. DOI: https://doi.org/10.1016/j.healthplace.2013.07.012
Dewulf B, Neutens T, De Weerdt Y, Van de Weghe N. 2013. Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas. BMC Family Pract 14:122. DOI: https://doi.org/10.1186/1471-2296-14-122
Eggleston K, Ling L, Qingyue M, Lindelow M, Wagstaff A, 2008. Health service delivery in China: a literature review. Health Econ 17:149-65. DOI: https://doi.org/10.1002/hec.1306
Guagliardo MF, 2004. Spatial accessibility of primary care: concepts, methods and challenges. Int J Health Geograph 3:1-13.
Gu X, Zhang L, Tao S, Xie B, 2019. Spatial accessibility to healthcare services in metropolitan suburbs: the case of Qingpu, Shanghai. Int J Environ Res Public Health 16:225. DOI: https://doi.org/10.3390/ijerph16020225
Health Bureau of Zhongshan , 2018. A snapshot of the development of health resources and medical services in Zhongshan in 2018. Available from: http://wjj.zs.gov.cn/xxml/tjgh/content/post_62028.html Accessed: 24 April 2021.
Hu W, Li L, Su M, 2019. Spatial inequity of multi-level healthcare services in a rapid expanding immigrant city of China: a case study of Shenzhen. Int J Environ Res Public Health 16:3441. DOI: https://doi.org/10.3390/ijerph16183441
Jay P, David S. 2016. Geographic distribution of hospital beds throughout China: a county-level econometric analysis. Int J Equity Health 15:1-8. DOI: https://doi.org/10.1186/s12939-016-0467-9
Jin M, Liu L, Tong D, Gong Y, Liu Y, 2019. Evaluating the spatial accessibility and distribution balance of multi-level medical service facilities. Int J Environ Res Public Health 16:7. DOI: https://doi.org/10.3390/ijerph16071150
Li L, Fu H, 2017. China’s health care system reform: progress and prospects. Int J Health Plan Manage 32:240-53. DOI: https://doi.org/10.1002/hpm.2424
Liu GG, Vortherms SA, Hong X, 2017. China’s health reform update. Annu Rev Public Health 38:431-48. DOI: https://doi.org/10.1146/annurev-publhealth-031816-044247
Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q, 2017. The primary health-care system in China. Lancet 390:2584-94. DOI: https://doi.org/10.1016/S0140-6736(17)33109-4
Luo W, Qi Y, 2009. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health Place 15:1100-107. DOI: https://doi.org/10.1016/j.healthplace.2009.06.002
Lu C, Zhang Z, Lan X, 2019. Impact of China’s referral reform on the equity and spatial accessibility of healthcare resources: a case study of Beijing. Soc Sci Med 235:112386. DOI: https://doi.org/10.1016/j.socscimed.2019.112386
Levesque JF, Harris MF, Russell G, 2013. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 12:18. DOI: https://doi.org/10.1186/1475-9276-12-18
Li L, Du Q, Ren F, Ma X, 2019. Assessing spatial accessibility to hierarchical urban parks by multi-types of travel distance in Shenzhen, China. Int J Environ Res Public Health 16:1039. DOI: https://doi.org/10.3390/ijerph16061038
McGrail MR, 2012. Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements. Int J Health Geogr 11:50. DOI: https://doi.org/10.1186/1476-072X-11-50
National Health Commission, 2019. China health statistics yearbook 2019. Peking Union Medical College Press, Beijing, China.
National Health Commission, 2020. China Health Statistics Yearbook. Peking Union Medical College Press, Beijing, China.
Oliver MA, Webster R, 1990. Kriging: a method of interpolation for geographical information systems. Int J Geograph Inf Syst 4:313-32. DOI: https://doi.org/10.1080/02693799008941549
Pan J, Liu H, Wang X, Xie H, Delamater PL, 2015. Assessing the spatial accessibility of hospital care in Sichuan Province, China. Geospat Health 10:384. DOI: https://doi.org/10.4081/gh.2015.384
Qingyue M, Daoxin Y, Anne M, Kamran A, 2019. China’s encouraging commitment to health. BMJ 365:l4178. DOI: https://doi.org/10.1136/bmj.l4178
Radke J, Lan M, 2000. Spatial decompositions, modeling and mapping service regions to predict access to social programs. Geogr Inf Sci 6:105-12. DOI: https://doi.org/10.1080/10824000009480538
Shan L， Qunhong W, Chaojie L, Ye L, Yu C, Zi L, Yanhua H, Libo L, Ning N, Ding D, Qingxia P, Liyuan H, 2017. Perceived challenges to achieving universal health coverage: a cross-sectional survey of social health insurance managers/administrators in China. BMJ Open 7:e014425. DOI: https://doi.org/10.1136/bmjopen-2016-014425
Song S, Yuan B, Zhang L, Cheng G, Zhu W, Hou Z, 2018. Increased Inequalities in Health Resource and Access to Health Care in Rural China. Int J Environ Res Public Health 16:49. DOI: https://doi.org/10.3390/ijerph16010049
Song P, Zhu Y, Mao X, Li Q, An L, 2013. Assessing spatial accessibility to maternity units in Shenzhen, China. PLoS One 8:e70227. DOI: https://doi.org/10.1371/journal.pone.0070227
Starfield B, 1994. Is primary care essential? Lancet 344:1129-33. DOI: https://doi.org/10.1016/S0140-6736(94)90634-3
Starfield B, Shi L, Macinko J, 2005. Contribution of primary care to health systems and health. Milbank Q 83:457-502. DOI: https://doi.org/10.1111/j.1468-0009.2005.00409.x
Tediosi F, Finch A, Procacci C, Marten R, Missoni E, 2016. BRICS countries and the global movement for universal health coverage. Health Policy Plan 31:717-28. DOI: https://doi.org/10.1093/heapol/czv122
Tao Z, Cheng Y, Liu J, 2020. Hierarchical two-step floating catchment area (2SFCA) method: measuring the spatial accessibility to hierarchical healthcare facilities in Shenzhen, China. Int J Equity Health 19:164. DOI: https://doi.org/10.1186/s12939-020-01280-7
Tao Z, Cheng Y, 2016. Research progress of the two-step floating catchment area method and extensions. Progr Geogr 35:589-99.
Tao Z, Cheng Y, Dai T, Li X, 2015. Spatial optimization of residential care facility locations in 2020 in Beijing:maximum equity in accessibility. Progr Geogr 34:1609-616.
Tao Z, Yao Z, Kong H, Duan F, Li G. 2018. Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs. BMC Health Serv Res 18:345. DOI: https://doi.org/10.1186/s12913-018-3132-8
World Health Organization, 2005. Sustainable health financing, universal coverage and social health insurance. World Health Assemb Resol 58:139-40.
Wang F, Xu Y, 2011. Estimating O–D travel time matrix by Google Maps API: implementation, advantages, and implications. Annals of GIS, 17(4), 199-209. doi:10.1080/19475683.2011.625977 DOI: https://doi.org/10.1080/19475683.2011.625977
Wang X, Yang H, Duan Z, Pan J, 2018. Spatial accessibility of primary health care in China: a case study in Sichuan Province. Soc Sci Med 209:14-24. DOI: https://doi.org/10.1016/j.socscimed.2018.05.023
Yip W, Fu H, Chen AT, Zhai T, Jian W, Xu R, Chen W, 2019. 10 years of health-care reform in China: progress and gaps in Universal Health Coverage. Lancet 394:1192-204. DOI: https://doi.org/10.1016/S0140-6736(19)32136-1
Yue Z, Qian W, Tian J, Jian W. 2018. Equity and efficiency of primary health care resource allocation in mainland China. Int J Equity Health 17:1-12. DOI: https://doi.org/10.1186/s12939-018-0851-8
Yang DH, Goerge R, Mullner R, 2006. Comparing GIS-based methods of measuring spatial accessibility to health services. J Med Syst 30:23-32. DOI: https://doi.org/10.1007/s10916-006-7400-5
Zhai K, Hou S, 2020. Green framework, implication and promotion scheme of high-quality development of urban-rural integration in China during the 14th Five-Year Plan Period. Reform 11:53-68.
Zhongshan Bureau of Statistics, 2019. Zhongshan statistical yearbook 2019. Available from: http://stats.zs.gov.cn/zwgk/tjxx/tjnj/content/post_1342223.html Accessed: 24 April 2021.
Zhao P, Li S, Liu D, 2020. Unequable spatial accessibility to hospitals in developing megacities: new evidence from Beijing. Health Place 65:102406. DOI: https://doi.org/10.1016/j.healthplace.2020.102406

How to Cite

Yue, J., Fu, Q., Zhou, Y., Zhang, Y., Ning, J., Yin, G., & Tao, H. (2021). Evaluating the accessibility to healthcare facilities under the Chinese hierarchical diagnosis and treatment system. Geospatial Health, 16(2). https://doi.org/10.4081/gh.2021.995

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.