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      A two-stage spatial allocation model for elderly healthcare facilities in large-scale affordable housing communities: a case study in Nanjing City

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          Abstract

          Background

          As the proportion of elderly residents living in large-scale affordable housing communities (LAHCs) increases in China, serious problems have become apparent related to the spatial allocation of elderly healthcare facilities (EHFs), e.g., insufficient provision and inaccessibility. To address these issues, this study developed a location allocation model for EHFs to ensure equitable and efficient access to healthcare services for the elderly in LAHCs.

          Methods

          Based on discrete location theory, this paper develops a two-stage optimization model for the spatial allocation of EHFs in LAHCs. In the first stage, the candidate locations of EHFs are specified using geographic information system (GIS) techniques. In the second stage, the optimal location and size of each EHF are determined based on the greedy algorithm (GA). Finally, the proposed two-stage optimization model is tested using the Daishan LAHC in Nanjing, Eastern China.

          Results

          The demand of the elderly for accessibility to EHFs is in line with Nanjing’s planning standards. Deep insights into spatial data are revealed by GIS techniques that enable candidate locations of EHFs to be obtained. In addition, the model helps EHF planners achieve equity and efficiency simultaneously. Two optimal locations for EHFs in the Daishan LAHC are identified, which in turn verifies the validity of the model.

          Conclusions

          As a strategy for allocating EHFs, this two-stage model improves the equity and efficiency of access to healthcare services for the elderly by optimizing the potential sites for EHFs. It can also be used to assist policymakers in providing adequate healthcare services for the low-income elderly. Furthermore, the model can be extended to the allocation of other public-service facilities in different countries or regions.

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          Most cited references47

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          Measurement, Optimization, and Impact of Health Care Accessibility: A Methodological Review.

          Fahui Wang (2012)
          Despite spending more than any other nation on medical care per person, the United States ranks behind other industrialized nations in key health performance measures. A main cause is the deep disparities in access to care and health outcomes. Federal programs such as the designations of Medically Underserved Areas/Populations and Health Professional Shortage Areas are designed to boost the number of health professionals serving these areas and to help alleviate the access problem. Their effectiveness relies first and foremost on an accurate measure of accessibility so that resources can be allocated to truly needy areas. Various measures of accessibility need to be integrated into one framework for comparison and evaluation. Optimization methods can be used to improve the distribution and supply of health care providers to maximize service coverage, minimize travel needs of patients, limit the number of facilities, and maximize health or access equality. Inequality in health care access comes at a personal and societal price, evidenced in disparities in health outcomes, including late-stage cancer diagnosis. This review surveys recent literature on the three named issues with emphasis on methodological advancements and implications for public policy.
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            Using a GIS-based network analysis to determine urban greenspace accessibility for different ethnic and religious groups

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              A survey of healthcare facility location

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                Author and article information

                Contributors
                gusweet@126.com
                lilingzhi5566@126.com
                njldz@126.com
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                12 December 2018
                12 December 2018
                2018
                : 17
                : 183
                Affiliations
                [1 ]ISNI 0000 0004 1761 0489, GRID grid.263826.b, School of Civil Engineering, , Southeast University, ; Jiangning District, Nanjing, 211189 China
                [2 ]ISNI 0000 0004 1937 2197, GRID grid.169077.e, Lyles School of Civil Engineering, , Purdue University, ; West Lafayette, IN 47907 USA
                [3 ]ISNI 0000 0000 9389 5210, GRID grid.412022.7, School of Civil Engineering, , Nanjing University of Technology, ; Nanjing, 211816 China
                Author information
                http://orcid.org/0000-0001-7123-0493
                Article
                898
                10.1186/s12939-018-0898-6
                6291974
                30541553
                db93a232-ab3c-4650-83e6-eef339a38015
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 June 2018
                : 28 November 2018
                Funding
                Funded by: The National Planning Office of Philosophy and Social Science of China
                Award ID: 14AJY013
                Award Recipient :
                Funded by: The MOE (Ministry of Education in China) Project of Humanities and Social Sciences
                Award ID: 15YJC790007
                Award Recipient :
                Funded by: The Philosophy and Social Science Foundation of Jiangsu Province, China
                Award ID: 2014ZDIXM008
                Award Recipient :
                Funded by: Postgraduate Research and Practice Innovation Program of Jiangsu Province
                Award ID: KYLX16_0303
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Health & Social care
                affordable housing,elderly healthcare facility,spatial allocation,geographic information system,greedy algorithm

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