Optimization and Adjustment of Multilevel Medical Facilities for the Elderly from the Perspective of Accessibility.

With the increasing aging and the accelerating urbanization of China, the layout of urban medical facilities should be adjusted to meet the needs of the elderly population. This paper takes Hefei, China, as the research object. A questionnaire survey was conducted on the elderly who went to different levels of medical facilities for daily medical treatment, and 2,271 valid questionnaires were collected. The survey found that an accessibility factor of medical facilities is a common concern for the elderly who go to facilities of different levels, which indicates that it is reasonable to optimize the layout of medical facilities at all levels from the perspective of accessibility. Results revealed that the elderly in Hefei considered living within 10 km from a tertiary hospital (referred to as a Grade A facility in this paper) was most ideal. Meanwhile, a primary or secondary hospital (a Grade B facility) was most accessible within 6 km, and within 1.5 km was the optimum accessibility distance for a community health service center (a Grade C facility). This study considered the aforementioned medical service radii suitable for the elderly. From this, the study evaluated the accessible service range of different levels of medical facilities suitable for the elderly through the network analysis in ArcGIS. Then, the scarce areas of medical services in the city could be determined. Through location–allocation models, it was found that to realize the ideal medical distance for the elderly, 2 additional facilities were needed for Grade A, 1 for Grade B, and 61 for Grade C. The results could provide references for subsequent urban medical construction and aging development in China. [ABSTRACT FROM AUTHOR]