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      Spatial Accessibility to Healthcare Services in Metropolitan Suburbs: The Case of Qingpu, Shanghai

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          Abstract

          Spatial accessibility is an important factor for planning healthcare services to maintain a quality life for the metropolitan area. The metropolitan suburb is a special area for its location and rapidly changing population during urbanization. Taking Qingpu district, a suburb of Shanghai as a case, this study evaluated the spatial accessibility to healthcare services of 203 villages and neighborhoods based on the Two-Step Floating Catchment Area (2SFCA) method by ArcGIS software. The result shows that the spatial accessibility in the whole district is quite uneven under lower thresholds, and the spatial differences are beyond the traditional zoning of East Qingpu, New City and West Qingpu. The worst accessibility was mainly distributed at the edges of Jinze, Liantang and Zhujiajiao, while the best accessibility was mainly distributed in the New City and the region close around it. The average value of the spatial accessibility in Qingpu is 2.84, with a reach equal under 90 min threshold by bus index of 2.85, or an under 60 min threshold by self-driving index of 2.70. Secondly, the difference shows a new pattern, that is the spatial accessibility could be affected by both the New City and the Central City. Thirdly, the transportation mode, urbanization, the density of road network and bus lines, as well as the number of doctors in each healthcare service would directly affect the spatial accessibility. Lastly, in order to improve the spatial accessibility in metropolitan suburbs, greater effort is needed in increasing the numbers of bus stations and doctors, especially the areas which are farthest from the New City or the Central City, such as Jinze, and Lian Tang town in Qingpu. We acknowledge that the public transportation is vital to the accessibility to healthcare services. We also emphasize that healthcare services should be planned based on the anticipated future trends of population agglomeration. Our results for Shanghai are applicable to other big cities that are experiencing similar rapid urbanization in China, or other developing countries in Southeast Asia, South Asia, South America and Africa.

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          Most cited references36

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          Measures of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region

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            Spatial accessibility of primary care: concepts, methods and challenges

            Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. Much less is known about the effect of distance to and supply of primary care on primary care utilization, particularly in the U.S. For several reasons the shortage of information is particularly acute for urban areas, where the majority of people live. First, explicit definitions and conceptualizations of healthcare access have not been widely used to guide research. An additional barrier to progress has been an overwhelming concern about affordability of care, which has garnered the majority of attention and research resources. Also, the most popular measures of spatial accessibility to care – travel impedance to nearest provider and supply level within bordered areas – lose validity in congested urban areas. Better measures are needed. Fortunately, some advances are occurring on the methodological front. These can improve our knowledge of all types of healthcare geography in all settings, including primary care in urban areas. This paper explains basic concepts and measurements of access, provides some historical background, outlines the major questions concerning geographic accessibility of primary care, describes recent developments in GIS and spatial analysis, and presents examples of promising work.
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              An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians.

              Wei Luo, Yi Qi (2009)
              This paper presents an enhancement of the two-step floating catchment area (2SFCA) method for measuring spatial accessibility, addressing the problem of uniform access within the catchment by applying weights to different travel time zones to account for distance decay. The enhancement is proved to be another special case of the gravity model. When applying this enhanced 2SFCA (E2SFCA) to measure the spatial access to primary care physicians in a study area in northern Illinois, we find that it reveals spatial accessibility pattern that is more consistent with intuition and delineates more spatially explicit health professional shortage areas. It is easy to implement in GIS and straightforward to interpret.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                15 January 2019
                January 2019
                : 16
                : 2
                : 225
                Affiliations
                [1 ]China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, China; guxk1980@ 123456sjtu.edu.cn (X.G.); bmxie1226@ 123456sjtu.edu.cn (B.X.)
                [2 ]School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, China
                [3 ]Shanghai Tong Ce Planning Design Co., Ltd., Shanghai 200023, China; hykayry@ 123456126.com
                Author notes
                [* ]Correspondence: zhanglf@ 123456sjtu.edu.cn
                Article
                ijerph-16-00225
                10.3390/ijerph16020225
                6352258
                30650552
                ffeec155-223a-4120-bdd2-aef7af6bca44
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 November 2018
                : 08 January 2019
                Categories
                Article

                Public health
                spatial accessibility,healthcare services,metropolitan suburb,2sfca,urban governance,shanghai

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