Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen, China

In the modern metropolis, the coverage of community hospitals is getting larger and larger. But high-level hospitals treating serious and sudden illness are still kind of scarce social resources. Shenzhen is the forefront of China's reform and opening up, its solution to the problem of medical allocation can be used as a reference for other cities. In this paper, we assume that primary, secondary and tertiary hospitals are main places for treating major diseases in Shenzhen, and analyze each sub-districts' spatial accessibility to them based on travel time and spatial difference within the city. A kernel density two-step floating catchment area method (KD2SFCA) is used to calculate how many medical resources each sub-district could share, in which the travel time from residential district to hospitals is used as an important parameter in evaluating the accessibility between suppliers and demanders. According to statistics of travel time by both driving and public transportation, the impedance function in KD2SFCA is modified and actual data of Shenzhen is used to fit its parameters, which could better simulate the attenuation trend of hospital service capabilities over the travel time. The spatial accessibilities are calculated under different travel modes and multiple time thresholds, and then spatial autocorrelation analysis method is used to analyze the spatial correlation of residents' accessibility to these medical resources. From both analysis of spatial accessibility and spatial autocorrelation, distinct variations in spatial distribution of high-level hospitals could be observed: of which the south and central parts of Shenzhen have significantly higher accessibilities, while the eastern and western regions are relatively lower. In particular, 12 sub-districts gain quite lower scores than others, showing that constructions on high-level hospitals should be strengthened further. In conclusion, the spatial configuration of high level hospitals in Shenzhen is not well balanced, Further optimization is urgently needed. (C) 2016 The Authors. Published by Elsevier Ltd.