Spatial Analysis of Hospital Accessibility in Nanjing: The Role of Community Health Service Centers

Amidst the spectrum of medical facilities, community health service centers (CHSCs) play an important role in alleviating the burden on hospitals. However, the intricate interaction between hospitals and CHSCs in accessibility analysis is often overlooked. To fill this gap, this study employs an enhanced gravity model to evaluate spatial accessibility of hospitals, focusing on both subdistrict and CHSC levels. The findings show that tertiary hospitals, providing the highest quality medical services, are concentrated in the central districts of Nanjing. Moreover, prevailing CHSC deployment plans risk an inequitable allocation of medical resources at the subdistrict level. In response, we proposed a collaborative mechanism that synergizing hospitals and CHSCs, built on a reciprocal medical alliance referral system. Specifically, our recommendations include: (1) promoting CHSCs to engage in alleviating the patient treatment load borne by tertiary hospitals in the central districts; and (2) balancing between the quality and quantity of CHSCs in the peripheral districts to increase accessibility for small-sized CHSCs in remote locations. This study contributes to the existing literature by incorporating CHSCs into hospital accessibility analysis and refining the framework for the spatial distribution of medical facility in alignment with established policies.