PROGRESS IN GEOGRAPHY ›› 2018, Vol. 37 ›› Issue (8): 1075-1085.doi: 10.18306/dlkxjz.2018.08.007

Special Issue: 人口与城市研究

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Spatial difference of medical facility accessibility and influencing factors: A comparative study of registered and floating populations in Shanghai

Yinhua TAO1,2(), Yue SHEN2,3,*()   

  1. 1. College of Urban and Environment Sciences, Peking University, Beijing 100871, China
    2. School of Urban and Regional Science, East China Normal University, Shanghai 200062, China
    3. The Center for Modern Chinese City Studies, East China Normal University, Shanghai 200062, China
  • Received:2017-08-02 Revised:2017-12-19 Online:2018-09-04 Published:2018-09-04
  • Contact: Yue SHEN;
  • Supported by:
    National Natural Science Foundation of China, No.41501180, No.41571144, No.41871166;"Chenguang Program" Supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission, No.17CG20;Open Projects Fund of Key Laboratory of Shanghai Urban Renewal and Spatial Optimization Technology, No.201830205


Since the central government proposed "balancing basic public services" in 2006 and the 2009 World Bank Development Report advocated "equal coverage of residents' access to public services," improving facility accessibility and spatial distribution have increasingly become one of the development goals for regional governments and hot topics for academic research. In Shanghai Municipality, accessibility of medical facilities in different regions within the city needs to be examined urgently because it is closely related to people's livelihood, health, and social justice. Based on the accessibility of tertiary, secondary, and community hospitals in Shanghai, this study analyzed the accessibility of medical facilities in different areas of the city, and the variation between the registered and floating populations. Improved potential model and multivariate linear regression model are used accordingly. The study further explored the influencing mechanism of individual accessibility of medical treatment. The results are as follows. First, the inner city is characterized by the highest regional accessibility of medical facilities, and accessibility is gradually reduced from the inner city to the suburbs. The fluctuation of hospital accessibility is relatively clear in the suburban area. Anting Town, Huaxin Town, and some other towns in the west of Shanghai still lack of medical facilities. Second, registered population's accessibility of medical treatment is better than that of floating population, and the most obvious difference between the two groups is found in the fringe of the central urban area and the inner suburban areas. Compared to the Pudong area, floating population in the Puxi area is facing more difficulties in seeking medical care. Third, residential location significantly affects accessibility of medical treatment. For the registered population, community hospitals are more accessible in outer suburbs, and secondary hospitals are more accessible in the fringe of the central urban area compared with the inner suburbs. For the floating population, the above variation is not significant. No matter which regions they live, they are generally facing severe medical accessibility problems. Finally, socioeconomic and institutional factors also have impacts on accessibility to medical facilities. Middle-aged and elderly residents with higher education have better access to medical facilities. Housing property rights and medical insurance are much related to registered population's medical accessibility, while economic factors matter more for floating population. This study provides some suggestions for the relevant government departments to identify areas lacking medical facilities and improve the spatial distributions of medical and public transport facilities, thus helping to achieve the goal of equal access of health care. Future studies need to consider the integrated impact of spatial and institutional factors on residents' medical preferences and behaviors.

Key words: medical facility, medical accessibility, social equity, improved potential model, Shanghai