Planning hierarchical hospital service areas for maternal care using a network optimization approach:A case study in Hubei,China

Improving maternal health is one of the Sustainable Development Goals.Hospital service areas(HSAs),which contain most hospitalization behaviors at the local scale,are crucial for health care planning.However,little attention has been given to HSAs for maternal care and the hierarchy structure.Considering Hubei,central China,as a case study,this study aims to fill these gaps by developing a method for delineating hierarchical HSAs for maternal care using a network optimization approach.The approach is driven by actual patient flow data and has an explicit objective to maximize the modularity.It also establishes the hierarchical structure of maternal care HSAs,which is fundamental for the planning of hierarchical maternal care and referral systems.In our case study,45 secondary HSAs and 22tertiary HSAs are delineated to achieve maximal modularity.The HSAs perform well in terms of indices such as the Localization Index and Market Share Index.Furthermore,there is a complementary relationship between secondary and tertiary hospitals,which suggests the need for referral system planning.This study can provide evidence for the validity of the HSA and the planning of maternal care HSAs in China.It also provides transferable methods for planning hierarchical HSAs in other developing countries.

Evaluating spatial accessibility to healthcare services from the lens of emergency hospital visits based on floating car data

Public medical facilities that are closely related to the health of residents have been recognised as one of the most crucial elements in sustainable urban planning.For the sake of social equality of medical services(especially for emergency medical conditions),the spatial distributions of medical resources need to be accurately measured and continuously optimized.This study presents an effective method to examine night emergency hospital visit and analyse its spatiotemporal characteristics using float car data(FCD).By extracting the hospital service areas,the two-step floating catchment area(2SFCA)methodology was improved to calculate hospital accessibility.Then,the balance between hospital accessibility and population density was analysed.In addition,we investigated the relationship between individual hospital choice preferences and hospital level and analysed several factors that affect individual choices.These results help us understand the special requirements and need of emergency hospital travel in cities and identify areas where medical resources are scarce.They can be used as guidance for urban hospital planning and construction.And the approach of hospital access behaviour investigation and the improved 2SFCA method can also provide insights for other activity-based travel behaviour research.