Assessing equity of the spatial distribution of primary health care facilities in Fuzhou City, China: A comprehensive method

Background
It is well known that equity assessment of the spatial distribution of primary health care facilities (PHCFs) is significant to optimize the allocation of health care resources and enhance the ability to react to public health emergencies, yet there is much discussion about the poor effectiveness of assessment for many cities due to the limitations of the insufficient ability of traditional data to reflect residents’ demands, etc. In many cities where PHCFs are inequity distributed, this is urgently needed for the government.

Methods
Using Fuzhou City, China as a case study, we propose a comprehensive method for assessing the equity that consisting of two frameworks based on the Geographic Information System. The first framework is assessing resident demand based on daily demand and potential demand, and the second is assessing PHCFs supply based on road impedance. This method combines an index system based on multi-source data and a spatial matching analysis between resident demand and PHCFs supply based on the supply-demand disparity index.

Results
The demand degree for the PHCFs and the supply degree of accessing the PHCFs of different residential areas differ to great extents. The equity of the spatial distribution of PHCFs shows well overall, but there is still a lack of equity in local areas. The number of the residential areas with the lowest equity, insufficient supply and oversupply accounted for 10.31% and 39.00% respectively; the former is mainly gathered in a concentrated form at the edge and in a scattered form inside, and the latter is distributed in the interior mostly in a concentrated manner.

Conclusion
The key findings highlight several aspects of improving the layout of PHCFs such as strengthen an in-depth analysis on residents’ demand. This study contributes to a more accurate equity assessment, and further improves the layout of health care facilities.