Spatial vertical equity in public general hospitals : towards a sustainable healthcare system

Abstract

The accessibility of public general hospitals is essential for the well-being of urban residents and for more equitable urban planning. However, public general hospitals and the associated spatial vertical equity are still not well known in developing countries. The objective of our study is to propose a theoretical framework to investigate the accessibility of public general hospitals and spatial vertical equity based on demographic dimensions. The main urban area of Wuhan is a suitable and representative example to explore this issue. An enhanced Gaussian two-step floating catchment area method, the Lorenz curve, and the Gini coefficient are employed in this study. The results indicate significant spatial heterogeneity in the accessibility of public general hospitals due to the dramatic transformation of urban planning and heterogeneous spatial structure. From a spatial vertical equity perspective, the spatial distribution of most public general hospitals does not take into account communities with a high proportion of minors and seniors. Compared with seniors, minors face more serious inequities in access to healthcare. The spatial distribution of only a few public general hospitals is prospective and inclined. Evidence-based policy implications are portrayed as a more equitable urban form and a sustainable healthcare system.