Assessing spatial equity in integrated health care facilities for older adults: a case study in the metropolis of Guangzhou, China.

Background: Ensuring equitable access to health care facilities for older adults is an increasingly important concern for academic researchers and policymakers in building age-friendly cities and communities. Previous studies have seldom explored the spatial equity in the distribution of geographic access to multi-tiered and multi-type health care facilities in China, especially community-based care for older adults. Methods: To compensate for this gap, this article adopted the two-step floating catchment area (2SFCA) method to systematically and dynamically evaluate equity in spatial accessibility by accounting for the category and hierarchy of health care facilities in Guangzhou by investigating the accessibility among 176 towns/districts and 973 health care facilities that were classified by municipal and community levels as well as medical facilities and nursing facilities in six different years. Results: The results suggested that the supply-demand relationships were regionally unbalanced in Guangzhou. The supply of all types of health care facilities in the suburban area was optimistic, whereas that in the central city was inadequate considering its high density of older adults. Accessibility on the outskirts was complex, and areas with insufficient supply. Moreover, community-level and nursing facilities had lower accessibility than municipal-level and medical facilities. Conclusion: Along with aging in the coming three decades, the supply-demand relationships of all health care facilities will lag in terms of supply. These findings may provide helpful insights for urban planners, and public officials with respect to the equal provision of health care resources and site allocations for older adults.