Research on the balanced geographic allocation of medical facilities in Shenzhen City based on the hierarchical medical system

Abstract Objective: Based on the hierarchical medical system, this study evaluated the accessibility of medical facilities (MFs), analyzed their geographic allocation, and put forward suggestions for the balanced allocation of MFs in Shenzhen. Methods: This study implemented a two-step floating catchment area (2SFCA) method to evaluate the accessibility of MFs. Statistical and spatial analysis methods were used to analyze the spatial characteristics and service equity of accessibility in Shenzhen. Results: The spatial allocation of the accessibility of low-level medical facilities (LMFs) in Shenzhen was characterized by the emergence of point-like high-accessibility areas in a large low-accessibility area. Here, there is the problem of insufficient service capacity, which limits the implementation of the hierarchical medical system. The spatial characteristics of the accessibility of high-level medical facilities (HMFs) in Shenzhen included a high degree of agglomeration, large differences inside and outside the original special economic zone (SEZ), and large areas with weak accessibility. There was a spatial imbalance in the overall accessibility of MFs, wherein individuals with higher incomes typically have better and more equitable accessibility. Conclusions: A balanced geographic allocation of MFs can ensure the implementation of the hierarchical medical system and enhance the equity of medical services. Strategies for balanced geographic allocation of MFs are proposed as follows: comprehensively improving the service capacity and construction standards of community healthcare centers (CHCs); promoting the construction of primary hospitals (PHs) and community hospitals (CHs) in areas with a high population density; establishing additional secondary hospitals (SHs) and tertiary hospitals (THs) in areas with low accessibility to HMFs; and encouraging coordinated urban development and medical facilities construction.