Improving the accessibility of medical services - building a close alliance between hospitals and community health service centers

In the medical system, community health service centers and hospitals share the responsibility of providing medical services for the society. Community health service centers play an indispensable role in alleviating the pressure of hospital diagnosis and treatment. Especially during the epidemic prevention and control period, community health service centers have assumed the important function of primary screening. However, little attention has been paid to the synergy between the two in terms of accessibility. In order to fill this research gap, we used an improved gravity model to evaluate the spatial distribution of hospitals in Nanjing and their accessibility at the street and community health service center levels.

Research Findings

The results show that the top three hospitals in Nanjing are mainly concentrated in the four central urban areas of Xuanwu, Qinhuai, Jianye and Gulou. The current planning of community health service centers may lead to an imbalance in the allocation of medical resources at the street level. We suggest that the two-way referral system based on the medical consortium should be established as an active cooperation mechanism between hospitals and community health service centers. At the same time, a regional medical consortium led by Jiangbei New District Hospital should be established in remote areas, and nearby Yangzhou and Zhenjiang should be included in the construction and development of regional medical consortium to improve the accessibility of medical services in Qixia District of Nanjing.

Policy recommendations

It is suggested that policy makers should guide community health service centers to share the pressure of diagnosis and treatment in tertiary hospitals in the centralarea of Nanjing ( Xuanwu District, Qinhuai District, Jianye District, Gulou District, Qixia District, Yuhuatai District ). In areas outside the central area of Nanjing, the relationship between the ability of community health service centers to provide medical services and the number of community health service centers is weighed to increase the accessibility of community health service centers in remote areas.

Research contribution

This study contributes to the existing literature by incorporating community health service centers into the analysis of hospital accessibility and improving the framework of hospital accessibility based on the existing medical consortium policy. A healthy community environment requires high-quality medical service support. We look forward to further strengthening the collaborative work between medical institutions through this research to ensure that residents in each community can easily obtain the required medical services, and then create a healthier and more convenient medical environment for the society. 

The study was published by the Shanghai Key Laboratory of Urban Design and Urban Science in collaboration with the team of associate professor Zhichang Cai,School of Architecture, Nanjing University of Technology. The medical health environment research team led by Zhichang Cai of the School of Architecture of Nanjing University of Technology has carried out extensive research on the correlation between the built environment of medical health and the users on different spatial scales of cities and buildings. In the early stage, the two sides have published two cooperative articles in the field of the relationship between urban built environment and public health. In the ' The Effect of the Built Environment on the COVID-19 Pandemic at the Initial Stage : A County-Level Study of the USA ' study, the impact of 17 urban built environment attributes on public health events was explored. The results show that some built-up environmental factors, such as road density and street intersection density, are significantly associated with COVID-19 infection rates. The relationship between population density and virus prevalence was positively correlated in the first two weeks, and then turned into a negative correlation.In the study of ' Satisfactions on Self-Perceived Health of Urban Residents in Chengdu, China : Gender, Age and the Built Environment ', the multivariate regression method was used to analyze the self-health perception of Chengdu residents in detail, revealing the different effects of gender, age and community type on residents ' health perception.

Article links :

Guan, C., Tan, J., Hall, B., Liu, C., Li, Y. and Cai, Z., 2022. The effect of the built environment on the COVID-19 pandemic at the initial stage: A county-level study of the USA. Sustainability, 14(6), p.3417.

Cai, Z., Guan, C., Trinh, A., Zhang, B., Chen, Z., Srinivasan, S. and Nielsen, C., 2022. Satisfactions on Self-Perceived Health of Urban Residents in Chengdu, China: Gender, Age and the Built Environment. Sustainability, 14(20), p.13389.