Examining gap between planned service levels and realistic demands of hospitals based on accessibility driven service area demarcation an empirical study of Dalian, P.R. China and Berlin, Germany

Abstract

The appropriate allocation and service level configuration of hospitals is of great importance in improving the quality of individuals’ life, as well as maintaining social security and social stability. Yet in traditional urban planning projects in China, hospitals are usually roughly configured and laid where the population of certain districts exceeds 1,000, i.e, according to an index of every one thousand persons, or where the residents of nearby communities could reach in 15 minutes by walk, i.e, according to standards of 15-minute life circle. Crude hospital configuration methods as such render potential gap between planned supplies and realistic demands of medical resources. Previous researches addressing such gap often rely on ex ante accessibility analysis such as network analysis via Geographic Information System, often failing to take into considerations realistic factors like traffic congestions, enclosures, and thus not precisely reflecting the actual travel time. To overcome the above defects, this study applies an ex post accessibility method, relying on online map providers to directly acquire real travel time. Firstly, Berlin is chosen as the comparison city for Dalian to draw guidance on hospital distribution due to its high development level and its similarities to Dalian in population and area. Secondly, grid points covering whole urban areas are generated for each city, and the travel time between each grid point and all hospitals are acquired from online map providers. Grid points are then assigned to hospitals with the shortest travel time, and realistic hospital service areas are thus demarcated. Thirdly, population distribution data are overlaid with realistic hospital service areas. Thus, it can be inferred to what amount of residents each hospital is burdened with, and whether this amount is appropriate given with the planned service level of each hospital. Finally, the results of Dalian are compared with Berlin, showing there is more apparent disparity in hospital spatial accessibility, and notable gap between planned service level and realistic demands of hospitals in Dalian. Discussions are later made to provide concrete suggestions for improved hospital allocation and configuration for Dalian. This research contributes to the expanding literature on hospital allocation and configuration in raising a novel method applicable for inference of the actual hospital service areas and service burden.