Supply-demand balance and spatial distribution optimization of primary care facilities in highland cities from a resilience perspective: A study of Lhasa, China.

Introduction: The development of urban resilience, which is fundamentally a balance between the supply capacity of primary care resources and the demand from urban residents, includes an appropriate architecture of primary care facilities. Resilient city construction in highland areas is hampered by the physical environment and transportation constraints and frequently encounters issues like poor accessibility and unequal distribution of primary care facilities. Methods: To optimize the supply and demand of primary care resources in highland cities and effectively improve the resilience of urban public health, this paper assesses the distribution of primary care facilities within the built-up area of Lhasa (China) through a spatial network analysis method based on GIS, combined with population distribution data, and employs a location-allocation model to optimize the distribution. Results: Firstly, the overall supply of primary care exceeds the overall demand, but the facilities' service area can only accommodate 59% of the residences. Secondly, there is a clear spatial variation in the accessibility of primary care facilities, and the time cost of healthcare is too high in some residences. Thirdly, the supply-demand relationship of primary care facilities is unbalanced, with both over-saturated and over-deficient areas. Discussion: After distribution optimization, the coverage and accessibility of primary care facilities have increased significantly, and the spatial imbalance of supply and demand has been alleviated. This paper proposes a research method to evaluate and optimize the spatial distribution of primary care facilities from multiple perspectives based on the resilience theory. The results of the study and visualization analysis methods can be used as an invaluable reference for planning the distribution of urban healthcare facilities and urban resilience construction in highland areas and other underdeveloped areas.