Optimizing the Equality of Healthcare Services in Wuhan, China, Using a New Multimodal Two-Step Floating Catchment Area Model in Conjunction with the Hierarchical Maximal Accessibility Equality Model

The equity of medical services is crucial for the quality of life of a population and the sustainable development of cities. Current research on optimizing the maximal equity of medical facilities has the following limitations: (1) In the accessibility calculation models for multiple transportation modes, the impact of factors such as public transport transfers and travel distance on the choice of transportation mode is often overlooked. (2) Existing spatial equity indicators are mostly derived from the overall study area, failing to fully consider the differences in population distribution and development gaps within different development zones inside the region. This study proposes a novel Incorporating Multiple Transportation Two-Step Floating Catchment Area (IMT-2SFCA) and a Hierarchical Theil-based Maximal Accessibility Equality model (HT-MAE) to optimize the equity of access to tuberculosis medical institutions in Wuhan. The findings reveal that, compared to single-mode transportation accessibility models, the multimodal accessibility model integrates the characteristics of four transportation modes, providing a more realistic reflection of residents' access to medical services. The optimization results show a significant improvement in the equity of access to medical services across Wuhan and among different economic development zones, although the equity indicators in non-central urban areas have declined. The results of this study provide a theoretical basis and practical insights for alleviating the inequality of access to medical services across different urban layers.