The social equity and the spatial accessibility of general hospitals in big Chinese cities: an exploration based on different income groups and transportation modes in Shenzhen

Abstract

Abstract Objectives: The rational planning and allocation of hospitals significantly improve residents’ health and quality of life. However, the unequal allocation of medical resources remains a significant issue in large Chinese cities. This study investigated the disparities in access to health care among different social groups in Shenzhen and explored the discrepancy in equity and its influencing mechanisms. Methods: The population was divided into 5 social groups based on housing prices: high-income, middle-high income, middle-income, middle-low income, and low-income. The actual travel times of residential neighborhoods and general hospitals under both driving and public transportation were accessed through the application programming interface Amap, a mapping technology application. The accessibility of general hospitals was calculated by the Gaussian-based 2-step floating catchment area method. The Gini coefficient was used to further investigate the equity in medical facility services. Results: Accessibility to first and second-level hospitals was adequate for the high-income group. However, a significant spatial mismatch in the allocation of hospitals was identified for the middle-low income and low-income groups, especially those reliant on public transportation. Conclusions: This study reveals an inequitable allocation of hospitals, with driving accessibility generally superior to public transport accessibility in Shenzhen, and a significant spatial mismatch for middle-low income and low-income groups. This study suggests optimizing public transportation around hospitals and middle-low income or low-income neighborhoods through urban planning to improve the accessibility of public service facilities for middle-low income and low-income households, thereby promoting more health equity.