Journal Article

Measuring and optimizing the spatial accessibility of primary health care in remote and rural areas: a case study of Liannan Yao Autonomous County in China

Sun, Ying, Wang, Lan, Xiang, Haiqing, Xiao, Yu, Zhong, Jiawei, Chen, Yaowen, Zhou, Peng, Liu, Lulu

2024

Overview

The need for equitable access to primary healthcare services in the current global context has attracted widespread attention, prompting nations to continuously enhance their grassroots medical service levels. In response, China launched the \"Healthy China\" initiative, which prioritizes the enhancement of national health as a core goal of the healthcare system and uses this opportunity to deepen reforms aimed at strengthening primary care. However, in remote and rural areas, the optimization of medical resource allocation and the achievement of balanced service development remain critical challenges owing to limited resources. This study selected Liannan Yao Autonomous County, which is situated in the northwestern corner of Guangdong Province, as a case study due to its remote mountainous location, underdeveloped economy, and minority region characteristics. Through field research and interviews, this study thoroughly explored the needs of both supply and demand, factoring in elements such as the service capability of healthcare facilities and residents' travel thresholds to enhance the two-step floating catchment area model, thus making it more applicable to remote villages. By integrating electric bikes and cars, which are the primary means of transportation in rural areas, this study conducted a thorough analysis and comparison of the accessibility of medical services in Liannan Yao Autonomous County (Liannan County) . The results reveal significant disparities in healthcare accessibility, an uneven distribution of medical resources, and varying impacts of transportation conditions and facility service capabilities on accessibility. Notably, the study revealed that improving transportation conditions alone has limited effects in rural areas; the key lies in balancing medical service capabilities and the rationality of overall layouts. From the perspectives of equity and efficiency, this study employs the equitable coverage model and the efficiency-driven model to construct two scenarios, comparing accessibility changes in Liannan County under both conditions and proposing strategies to improve the spatial layout of local healthcare facilities. This research not only deepens the understanding of healthcare service accessibility in rural areas but also provides a scientific basis for optimizing resource allocation and enhancing primary medical services, offering valuable guidance and reference for Liannan County and other similar rural regions.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: 2SFCA / Case studies / China / Comparative analysis / Health Administration / Health care policy / Health facilities / Health Informatics / Health services / Health Services Accessibility - organization & administration / Health Services Accessibility - statistics & numerical data / Humans / Management / Medicine / Medicine & Public Health / Nursing Research / Organizational Case Studies / Population density / Primary care / Primary health care / Primary Health Care - organization & administration / Public Health / Remote and rural area / Research methodology / Resource optimization allocation / Rural areas / Rural health services / Rural Health Services - organization & administration / Rural Health Services - statistics & numerical data / Rural health services research / Rural Population - statistics & numerical data / Spatial accessibility / Supply and demand