Evaluating the inequality of medical resources allocation based on spatial and non-spatial accessibility: A case study of Wenzhou, China

Abstract Background: Environmental and social factors that impact resource allocation in rural, developing regions are key social determinants of health that require multi-sector collaboration to improve health opportunities. Thus, we sought to evaluate the spatial distribution and accessibility of medical resources to assess current disparities, determine best practices for resource allocation, and inform policies to improve regional health planning.Methods: We used the Gini coefficient and agglomeration degree to measure inequality among the frequency distribution of medical resources in Wenzhou, China. We applied the modified hierarchical two-step floating catchment area (H2SFCA) method to evaluate the spatial accessibility of medical institutions across the city. Finally, we explored the influencing factors of accessibility differences using the spearman correlation analysis. Results: The distribution of medical resources in Wenzhou is inequitable according to population and geographical distribution. The overall spatial accessibility of Wenzhou is poor, the accessibility of east region is higher than west region, and the accessibility of different levels of medical institutions varies greatly. Accessibility is positively correlated with the number of institutions (ρ=0.585), the number of doctors (ρ=0.670), population density (ρ=0.769), road density (ρ=0.792), and GDP (ρ=0.310).Conclusions: There are disparities in the spatial and unbalanced distribution of medical resources in Wenzhou. Policies and initiatives to improve the geographical distribution of resources, construct connected road networks, and enhance resident access to medical resources are needed.