Measuring spatial accessibility and disparity to county hospitals in western China: based on the web map navigation data

Abstract

Background The Chinese government proposed the initiative of "XIAO BING BU CHU CUN, DA BING BU CHU XIAN” in 2016, which means the rate of health care service provided by county hospitals should reach 90%. The prerequisite for achieving this goal is that residents can access to county hospitals’ services conveniently and impartially. However, little research reported the level of spatial accessibility of county hospitals in western China. Therefore, we aim to measure the spatial accessibility to county hospitals of county residents and identify regional disparities in Shaanxi Province in western China. Methods We implemented a novel method – navigation data of the AutoNavi map (knows as Gaode map in Chinese) – to assess time and distance from villages and neighborhoods to county hospitals. The navigation data was collected by requesting an application-programming-interface using a web crawler in Python. The minimum driving time and distance were extracted from the navigation data. The travel impedance to the nearest provider was used to measure spatial accessibility. Results The results show that county residents in northwestern China's Shaanxi Province have poor spatial accessibility to county hospitals. Only 68.8% of villages and neighborhoods can reach the county hospitals within 60 minutes, while 13.4% of them are reachable beyond 90 minutes. Moreover, a significant within-province disparity exists, with residents in the central area most accessible to county hospitals, while the north and south areas still need improvement. Conclusions Health resource planning is required to improve spatial accessibility and eliminate the regional disparity. Further studies are called for to integrate navigation data of web map with GIS methods to measure spatial accessibility of health facilities in more complex contexts.