Accessibility and Optimization of Rural Healthcare Facilities From the Perspective of the Rural Living Circle

China's rural revitalization strategy emphasizes the integration of urban and rural development, with the rural living circle serving as a fundamental unit. Public service facilities, especially medical services, are crucial for the well-being of rural residents. Essential for achieving balanced development and improved living standards, these services must ensure equitable access in rural areas, balancing social justice with humanitarian considerations. A comprehensive examination of their availability and interaction with the living circle is key to optimizing these facilities for balanced progress. This study focused on Qin'an County, Gansu, China, where it mapped out living circles based on residents' travel habits and the levels of medical institutions. It analyzed the distribution and accessibility of medical facilities within these circles, investigating their correlation with circle radii. The findings were aimed at enhancing the spatial layout of medical services, yielding three key insights: (1) The spatial layout of rural medical facilities in Qin'an County shows a "core–edge" trend, with most areas by low accessibility, in contrast to the high accessibility in the urban center. (2) A significant negative correlation was identified between the accessibility of medical facilities and the radius of the living circle; in other words, greater accessibility corresponds to a smaller living circle radius. (3) The K-means clustering algorithm proved to be an effective method for optimizing the accessibility of medical facilities, leading to improved access and more balanced distribution across living areas. In China's new stage of development, understanding the complex dynamics of the "people-land" relationship is crucial. The spatiotemporal development pattern, orientation difference characteristics, and spatial optimization layout of rural medical provide guidance for decision making regarding equity and quality improvement of rural public health services.