Improving Spatial Equality in Primary Healthcare Facilities Through a Minimum Distance and Spatial Envy Location Model: A Case Study in Changyuan, China

Equitable access to primary healthcare services can considerably improve citizens' health and well-being. However, most location-allocation models emphasize efficiency, such as minimizing total travel cost and maximizing demand coverage while overlooking spatial equality. Therefore, this study addresses the issue of spatial equality planning for primary healthcare facilities by proposing a new framework for evaluation, optimization, and validation. Using the county-level city of Changyuan in China as a case study, the researchers adopted an optimal supply-demand allocation model to assess the spatial accessibility of primary healthcare facilities. Moreover, this study examines the capacitated minimum distance and envy location problem (CMDELP) model to recognize optimal locations for new healthcare facilities. The results showed that people prefer to use electric bicycles as their mode of transportation, with 74.95% of the people reaching the nearest healthcare facility within 15 min under the electric bicycle scenario. The Gini coefficient was 0.454. By incorporating the newly proposed facilities, whose optimal locations were determined using the p-median problem (PMP) model, capacitated p-median problem (CPMP) model, and CMDELP models, additional people coverage for the electric bicycle scenario could potentially increase by 17.47%, 15.00%, and 18.39%, respectively, while the Gini coefficient decreases to 0.325, 0.332, and 0.277, respectively. The proposed solution for optimizing the layout of public service facilities has the potential to be a useful tool for improving the spatial equality of facilities at the county level.