Measuring spatial accessibility to medical facilities: Aligning with actual medical travel behavior

Guided by the concept of “people-centered,” methods for measuring spatial accessibility to medical facilities, rooted in behavioral geography and human-centered paradigm, have attracted significant scholarly attention and emerged as a critical focus in urban planning research. Enhancing spatial accessibility to medical facilities is an important public health in global and local policy frameworks. However, the effectiveness of improved spatial accessibility in addressing healthcare challenges remains uncertain, given the complexity of individual-level medical travel behavior. In this study, we developed a multimodal medical travel chain and proposed a spatial accessibility model that incorporates the characteristics of medical travel. We aim to provide a theoretical foundation for “people-centered” medical facility planning. The results indicate that: (1) Travel impedance affects both the travel limit threshold and modal share, thereby influencing preferences for medical travel behavior. Specifically, walking and cycling have lower modal shares due to their lower tolerance for travel impedance, whereas driving and public transportation demonstrate higher modal shares under high travel impedance conditions. (2) The variability in medical travel times results in temporal differences in spatial accessibility. Despite minimal fluctuations in travel times across different dates, a distinct tidal pattern emerges when examining various time intervals. (3) By introducing travel shares and selecting optimal travel limit thresholds and impedance coefficients, the spatial accessibility that reflects medical travel features can more accurately prevent localized overestimation or underestimation. Overall, we developed a research methodology that integrates medical travel features with spatial accessibility. This method provides insights into the spatiotemporal constraints experienced by residents and accesses the effectiveness of medical resource allocation strategies. It offers empirical evidence for optimizing the allocation of medical facilities in developing countries globally.