Influences of Spatial Accessibility and Service Capacity on the Utilization of Elderly-Care Facilities: A Case Study of the Main Urban Area of Chongqing

Abstract

With the unprecedented growth of the elderly population in China, elderly-care facilities (ECFs) are in a fast expansion process. However, limited attention has been paid to the imbalance at the actual utilization level of ECFs. This research aims to reveal the spatial inequity of ECFs and to quantitatively examine the effect of accessibility and institutional service capacity on utilization. Taking Chongqing, China, as the study area, we measured the spatial accessibility of different travel modes by the Gaussian Two-Step Floating Catchment Area (G2SFCA) method and investigated distribution differences in spatial accessibility, service capacity, and utilization of ECFs by the Dagum Gini Coefficient and its decomposition. Then, the impact of spatial accessibility and service capacity on the utilization of regional ECFs was quantified by multiscale geographically weighted regression (MGWR). The study findings can be summarized as follows. (1) Walking accessibility has the most significant impact on the utilization of ECFs and shows geographic heterogeneity. Developing a pedestrian-oriented network of pathways is essential to enhance the utilization of ECFs. (2) Accessibility by driving and bus-riding does not correlate with regional ECFs utilization, and relevant studies cannot rely on them alone for assessing the equity of ECFs. (3) In the utilization of ECFs, since the inter-regional difference is more significant than the intra-regional difference, efforts to reduce the overall imbalance should be oriented toward inter-regional variation. The study’s findings will assist national policymakers in developing EFCs to enhance health indicators and quality of life for older adults by prioritizing financing for shortage areas, coordinating ECFs services, and optimizing road systems.

Factors Influencing the Usage Frequency of Community Elderly Care Facilities and Their Functional Spaces: A Multilevel Based Study

“…Nevertheless, the elderly's demand for legal consultation is not high, and they could get access to such kind of service in places other than CSCF [86,87]. In such cases, accessibility and other convenient factors of the built environment become more crucial [38,88], and the elderly are more likely to choose the legal consultation room of CECF in the nearby neighborhood.…”

“…In addition to individual differences that result in different service demands in CECF, the coverage and accessibility of CECF also show how the built environment around facilities influences the frequency used by older people [37,38]. These factors include the conditions of road traffic, the density of transportation stations (bus and subway stations), and the development of the area surrounding CECF [39,40].…”

“…The built environment of the subdistrict. Coverage and accessibility of elderly care stations play crucial roles in elderly utilization choices [38,55]. The area occupancy rate of CECSs within the subdistrict indicates facility coverage, while the road density and mean distance from CECSs to public transportation stops are indicators of accessibility [37].…”