ArticleInternational journal for equity in health2021
An integrated analysis of spatial access to the three-tier healthcare delivery system in China: a case study of Hainan Island.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Trends in maternal mortality in China and Hainan Province: an analysis based on GBD 2023 and Hainan surveillance data.Frontiers in global women's health · 2026Article
- Recognition of worsening heart failure symptoms, help-seeking attitudes, and time-to-presentation in chronic heart failure: a single-center KAP study in China.Frontiers in cardiovascular medicine · 2026Article
- Assessing three-decade HIV testing transformation: TOPSIS-radar evaluation of tiered health system performance in rural-urban Southwestern China.BMC public health · 2025Article
- Factors influencing rehabilitation costs for stroke inpatients in Shenzhen: a multicenter retrospective study.BMC public health · 2025Article
- Characteristics and risk factors for medical malpractice among obstetric and gynecologic physicians in China.BMC health services research · 2025Observational
- Assessment of sanitation facilities in primary healthcare institutions across seven provinces in China: a cross-sectional study.BMC public health · 2025Article
- Exploring the Dynamics of Dietary Self-Monitoring Adherence Among Participants in a Digital Behavioral Weight Loss Program: Model Development Study.Journal of medical Internet research · 2025Article
- Does the reduction in obstetric hospitals result in an unintended decreased in-hospital delivery utilisation? A causal multilevel analysis in China.BMJ public health · 2025Article
- Spatiotemporal disparities in maternal mortality and the role of multiscale administrative levels: a 20-year study across Chinese counties.Frontiers in public health · 2025Article
- Spatial Access to Continuous Maternal and Perinatal Health Care Services in Low-Resource Settings: Cross-Sectional Study.JMIR public health and surveillance · 2024Article
- Is low-dose computed tomography for lung cancer screening conveniently accessible in China? A spatial analysis based on cross-sectional survey.BMC cancer · 2024Article
- Revealing spatiotemporal inequalities, hotspots, and determinants in healthcare resource distribution: insights from hospital beds panel data in 2308 Chinese counties.BMC public health · 2024Article
- Editorial: Applications of geospatial information technologies and spatial statistics in health services research.Frontiers in public health · 2023Article
- Assessing the impact of urban greenspace on physical health: An empirical study from Southwest China.Frontiers in public health · 2023Article
- Research on the Equity and Optimal Allocation of Basic Medical Services in Guangzhou in the Context of COVID-19.International journal of environmental research and public health · 2022Article
- Use of Social Media for Implementing Diagnoses, Consultation, Training, and Case Reporting Among Medical Professionals to Improve Patient Care: Case Study of WeChat Groups Across Health Care Settings.JMIR medical education · 2022Article
- Supply-demand matching of medical services at a city level under the background of hierarchical diagnosis and treatment - based on Didi Chuxing Data in Haikou, China.BMC health services research · 2022Article
- An External Patient Healthcare Index (EPHI) for Simulating Spatial Tendencies in Healthcare Seeking Behavior.Frontiers in public health · 2022Article
- An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare.International journal for equity in health · 2021Article
- The Contributions of Population Distribution, Healthcare Resourcing, and Transportation Infrastructure to Spatial Accessibility of Health Care.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
4 authors.
Funding
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Abstract
backgroundAccess to healthcare is critical for the implementation of Universal Health Coverage. With the development of healthcare insurance systems around the world, spatial impedance to healthcare institutions has attracted increasing attention. However, most spatial access methodologies have been developed in Western countries, whose healthcare systems are different from those in Low- and Middle-Income Countries (LMICs).
methodsHainan Island was taken as an example to explore the utilization of modern spatial access techniques under China's specialized Three-Tier Health Care Delivery System. Healthcare institutions were first classified according to the three tiers. Then shortest travel time was calculated for each institution's tier, overlapped to identify eight types of multilevel healthcare access zones. Spatial access to doctors based on the Enhanced Two-Step Floating Catchment Area Method was also calculated.
resultsOn Hainan Island, about 90% of the population lived within a 60-min service range for Tier 3 (hospital) healthcare institutions, 80% lived within 30 min of Tier 2 (health centers), and 75% lived within 15 min of Tier 1 (clinics). Based on local policy, 76.36% of the population living in 48.52% of the area were able to receive timely services at all tiers of healthcare institutions. The weighted average access to doctors was 2.31 per thousand residents, but the regional disparity was large, with 64.66% being contributed by Tier 3 healthcare institutions.
conclusionSpatial access to healthcare institutions on Hainan Island was generally good according to travel time and general abundance of doctors, but inequity between regions and imbalance between different healthcare institution tiers exist. Primary healthcare institutions, especially in Tier 2, should be strengthened.
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