A two-stage spatial allocation model for elderly healthcare facilities in large-scale affordable housing communities: a case study in Nanjing City

Abstract

BackgroundAs the proportion of elderly residents living in large-scale affordable housing communities (LAHCs) increases in China, serious problems have become apparent related to the spatial allocation of elderly healthcare facilities (EHFs), e.g., insufficient provision and inaccessibility. To address these issues, this study developed a location allocation model for EHFs to ensure equitable and efficient access to healthcare services for the elderly in LAHCs.MethodsBased on discrete location theory, this paper develops a two-stage optimization model for the spatial allocation of EHFs in LAHCs. In the first stage, the candidate locations of EHFs are specified using geographic information system (GIS) techniques. In the second stage, the optimal location and size of each EHF are determined based on the greedy algorithm (GA). Finally, the proposed two-stage optimization model is tested using the Daishan LAHC in Nanjing, Eastern China.ResultsThe demand of the elderly for accessibility to EHFs is in line with Nanjing’s planning standards. Deep insights into spatial data are revealed by GIS techniques that enable candidate locations of EHFs to be obtained. In addition, the model helps EHF planners achieve equity and efficiency simultaneously. Two optimal locations for EHFs in the Daishan LAHC are identified, which in turn verifies the validity of the model.ConclusionsAs a strategy for allocating EHFs, this two-stage model improves the equity and efficiency of access to healthcare services for the elderly by optimizing the potential sites for EHFs. It can also be used to assist policymakers in providing adequate healthcare services for the low-income elderly. Furthermore, the model can be extended to the allocation of other public-service facilities in different countries or regions.

Demand for community-based care services and its influencing factors among the elderly in affordable housing communities: a case study in Nanjing City

“…One possible explanation is that the income of the elderly in the AHCs is generally low and thus their safety needs lower down in Maslow's hierarchy have not yet been satisfied [45]. More seriously, insufficient provision of elderly healthcare facilities, poor accessibility of existing facilities, and lack of professional services have been the main barriers to the supply of medical care services due to the innate characteristics of the AHCs [5]. Similarly, the elderly in low-income countries tend to have less access to health services than those in high-income countries [46].…”

“…The principal reason is that the proportion of the elderly in Daishan AHC is much higher than the overall population of the elderly in Nanjing. Another reason is that urgent demand has been caused for community-based care services due to the lack of elderly facilities [5]. In 2017, the number of elderly people living in Daishan AHC was nearly 30,000.…”

“…To address the severe aging problem in China, community-based care, defined as professional care provided at home to the elderly with formally assessed demands, has been advocated and become an increasingly significant mode of care provision [3,4]. For instance, in 'the 13 th five year national plan (2016-2020) for developing the elderly care system' issued in 2017, it is required to give priority to the development of community-based care services [5]. Nevertheless, recent studies have illustrated that many studies paid more attention on improving the accessibility of elderly facilities than on the utilization of community-based care related to the demand side [6][7][8].…”

“…In particular, the proportion of the elderly in these communities is higher than in other residential communities [16]. For example, by the end of 2017, the proportion of the elderly in the Daishan AHC (one of the AHCs in Nanjing) had reached 30%, which far exceeded the overall proportion of the elderly in Nanjing (20.85%) [5]. Due to these innate characteristics of the AHCs, the demands for community-based care services in these communities are rapidly increasing while the quantity of these services is seriously inadequate [17].…”

“…Previous studies on the AHCs mainly focus on the allocation of elderly healthcare facilities [5], impacts of indoor facilities management on the quality of life of the elderly [18], social impact assessment of affordable housing projects [15], assessment of elderly-adaptability level [19]. There are limited studies concerning the demand of the elderly for community-based care services in the AHCs of China.…”