Service Flow in Multilayer Networks: A Method for Evaluating the Layout of Urban Medical Resources

Authors: Guanglin Song

Abstract:

Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city. The findings reveal that: 1) There exists overall maldistribution and over-concentration of healthcare resources in the study area, characterized by structural imbalance. 2) The low rate of primary care utilization in the study area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem. 3) Gradual optimization of the healthcare facility layout in the study area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance. This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. In addition, the study provides some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: Flow of public services, healthcare facilities, spatial planning, urban networks.

References:

[1] Rhodes R., Margaret P. B., Silwers A. Medicine and Scocial Justice. New York: Oxford University Press, 2002.
[2] Qian D., Lucas H., Chen J. Determinants of the Use of Different Types of Health Care Providerin Urban China: A Tracer Illness Study of UR⁃ TI. Health Policy, 2010.
[3] Chongxu Z., Lizhong D., Hangyu L., et al. Identifying the influencing factors of patient’s attitude to medical service price by combing grey relational theory with CMH statistical analysis. Journal of Grey System, 2020.
[4] Pei X., Bloom G. Balancing Efficiency and Legitimacy: Institutional Changes and Rural Health Organization in China: Balancing Efficiency and Legitimacy. Social Policy & Administration, 2011.
[5] Drezner Z., Marianov V., Wesolowsky G. O. Maximizing the minimum cover probability by emergency facilities. Annals of Operations Research, 2016.
[6] Francis J. R., Verma S., Bonney D. Disparity in distribution of inpatient hospital services in Australia. Australian and New Zealand Journal of Public Health, 2020.
[7] Teach S. J., Guagliardo M. F., Crain E. F., et al. Spatial Accessibility of Primary Care Pediatric Services in an Urban Environment: Association With Asthma Management and Outcome. Pediatrics, 2006.
[8] Lin Lin, Yan Chengqi, Yang Ying, et al. The behavior and influencing factors of elderly people in Guangzhou seeking medical treatment for minor and chronic diseases through the "bypass" approach. Tropical Geography, 2020.
[9] Tao Z., Cheng Y., Bai L., et al. Planning hierarchical hospital service areas for maternal care using a network optimization approach: A case study in Hubei, China. Journal of Geographical Sciences, 2022.
[10] Zhao Jinming, Bing Longfei, Feng Haozhou, et al. Research on Influencing Factors of Community Residents' Healthcare Seeking Behavior under the Context of Tiered Medical Service System. China Health Administration, 2023.
[11] Andersen R. M. Families’ Use of Health Services: A Behavioral Model of Predisposing, Enabling, and Need Components. 1968.
[12] Tang C., Dong X., Lian Y., et al. Do Chinese hospital services constitute an oligopoly? Evidence of the rich-club phenomenon in a patient referral network (J). Future Generation Computer Systems, 2020.
[13] Gao J., Yang X., Tang L., et al. Understanding urban hospital bypass behaviour based on big trace data. Cities.
[14] He Yu, Medical Behavior Selection and Graded Diagnosis and Treatment System: An Economic Theoretical Framework. China's health economy, 2017.
[15] Wei Luo, Fahui Wang, Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region. Environment and Planning, 2003.
[16] Li Pinghua, Lu Yulin, Theoretical and methodological review of urban accessibility research.Urban Problems, 2005.
[17] Hansen W., How Accessibility Shapes Land-Use. Journal of the American Institute of Planners, 1959.
[18] Koenig J., Indicators of Urban Accessibility - Theory and Application. Transportation, 1980.
[19] Coulter P. B. Measuring the Inequity of Urban Public Services Methodological Discussion With Applications*. Policy Studies Journal, 1980.
[20] Guagliardo M. F., Spatial accessibility of primary care: concepts, methods and challenges. International journal of health geographics, 2004.
[21] Liu Xianteng. A review of research on spatial accessibility. Urban Traffic, 2007.
[22] Chen Jie, Lu Feng, Cheng Changxiu, Review of research progress on accessibility measurement methods and their applications. Progress in Geographic Science, 2007.
[23] Li Pinghua, Lu Yulin. Review and prospect of accessibility research. Progress in Geographic Science, 2005.