{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:03:38Z","timestamp":1792425818934,"version":"4.5.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1890540","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:31Z","timestamp":1783916611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing spatial equity in integrated health care facilities for older adults: a case study in the metropolis of Guangzhou, China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yingsheng","family":"Liu","sequence":"first","affiliation":[{"name":"College of Forestry and Landscape Architecture, South China Agricultural University","place":["Guangzhou, China"]},{"name":"Simon Fraser University, Burnaby","place":["BC, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changdong","family":"Ye","sequence":"additional","affiliation":[{"name":"College of Forestry and Landscape Architecture, South China Agricultural University","place":["Guangzhou, China"]},{"name":"Key Laboratory of Natural Resources Monitoring in Tropical and Subtropical Area of South China, Ministry of Natural Resources","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Architectural Engineering, Shenzhen Polytechnic University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailun","family":"Fang","sequence":"additional","affiliation":[{"name":"Guangzhou Urban Planning and Design Co., Ltd.","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyang","family":"Mi","sequence":"additional","affiliation":[{"name":"College of Forestry and Landscape Architecture, South China Agricultural University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jtrangeo.2014.12.006","article-title":"Accessibility, equity and health care: review and research directions for transport geographers","volume":"43","author":"Neutens","year":"2015","journal-title":"J Transp Geogr"},{"key":"B2","article-title":"Peak global population and other key findings from the 2024 UN World Population Prospects","author":"Ritchie","year":"2024","journal-title":"Our World in Data"},{"key":"B3","article-title":"World Social Report 2023: Leaving No One Behind in an Ageing World","author":"Wilmoth","year":"2023"},{"key":"B4","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.cities.2016.03.016","article-title":"Can global cities be \u2018age-friendly cities'? Urban development and ageing populations","volume":"55","author":"Buffel","year":"2016","journal-title":"Cities"},{"key":"B5","article-title":"Zhongguo tongji nianjian [China statistical yearbook]","author":"China","year":"2021","journal-title":"Beijing: China Statistic Press"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1016\/S0140-6736(20)32136-X","article-title":"Long-term care system for older adults in China: policy landscape, challenges, and future prospects","volume":"396","author":"Feng","year":"2020","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"10282","DOI":"10.3390\/app112110282","article-title":"Towards health equality: optimizing hierarchical healthcare facilities towards maximal accessibility equality in Shenzhen. China","volume":"11","author":"Tao","year":"2021","journal-title":"Appl Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-117773\/v1","article-title":"Influencing factors and functioning mechanism of the service experience of elderly care when integrated with health care in China: a qualitative study","author":"Liu","year":"2020"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/aepr.12098","article-title":"Population ageing and social security in Asia","author":"Chomik","year":"2015","journal-title":"Asian Economic Policy Review"},{"key":"B10","doi-asserted-by":"publisher","first-page":"100926","DOI":"10.1016\/j.jth.2020.100926","article-title":"Examining geographical accessibility to multi-tier hospital care services for the elderly: a focus on spatial equity","volume":"19","author":"Cheng","year":"2020","journal-title":"J Transp Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1016\/S0140-6736(19)32136-1","article-title":"Ten years of health-care reform in China: progress and gaps in Universal Health Coverage","volume":"394","author":"Yip","year":"2019","journal-title":"Lancet"},{"key":"B12","doi-asserted-by":"publisher","first-page":"28","DOI":"10.5334\/ijic.5946","article-title":"Older adults' demand for integrated care and its influencing factors: a scoping review","volume":"21","author":"Wang","year":"2021","journal-title":"Int J Integr Care"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2991\/978-94-6463-036-7_232","article-title":"Investigation and Research Based on the Prediction and Planning of Community Home Care Service Center in Tianhe District, Guangzhou","author":"Wang","year":"2022","journal-title":"Proceedings of the 2022 2nd International Conference on Economic Development and Business Culture (ICEDBC 2022)."},{"key":"B14","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1007\/s12603-021-1595-5","article-title":"Medical and old-age care integration model and implementation of the integrated care of older people (ICOPE) in China: opportunities and challenges","volume":"25","author":"Zhou","year":"2021","journal-title":"J Nutr Health Aging"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.3390\/healthcare13141637","article-title":"Home-based community elderly care quality indicators in China: a systematic literature review","volume":"13","author":"Chen","year":"2025","journal-title":"Healthcare"},{"key":"B16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.60027\/ijsasr.2025.6843","article-title":"Research on community day care centers for the elderly in China","volume":"5","author":"Che","year":"2025","journal-title":"Int J Sociol Anthropol Sci Rev"},{"key":"B17","doi-asserted-by":"publisher","first-page":"107","DOI":"10.5582\/bst.2022.01068","article-title":"Current state of care for the elderly in China in the context of an aging population","volume":"16","author":"Bao","year":"2022","journal-title":"Biosci Trends"},{"key":"B18","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.socscimed.2018.07.030","article-title":"Community-engaged development of a GIS-based healthfulness index to shape health equity solutions","volume":"227","author":"Sadler","year":"2019","journal-title":"Soc Sci Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12939-019-0998-y","article-title":"Institutional differences and geographical disparity: the impact of medical insurance on the equity of health services utilization by the floating elderly population-evidence from China","volume":"18","author":"Han","year":"2019","journal-title":"Int J Equity Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"103541","DOI":"10.1016\/j.cities.2021.103541","article-title":"Analyzing spatiotemporal accessibility patterns to tertiary healthcare services by integrating total travel cost into an improved E3SFCA method in Changsha, China","volume":"122","author":"Xing","year":"2022","journal-title":"Cities"},{"key":"B21","doi-asserted-by":"publisher","first-page":"80","DOI":"10.15957\/j.cnki.jjdl.2026.02.008","article-title":"Dynamic measurement of emergency medical care accessibility for the elderly and its spatial equity assessment: a case study of city center of Zhengzhou","volume":"46","author":"Ning","year":"2026","journal-title":"Econ Geogr"},{"key":"B22","doi-asserted-by":"publisher","first-page":"113834","DOI":"10.1016\/j.socscimed.2021.113834","article-title":"Towards healthy China 2030: Modeling health care accessibility with patient referral","volume":"276","author":"Xiao","year":"2021","journal-title":"Soc Sci Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"493","DOI":"10.3390\/ijerph16030493","article-title":"Spatial equity of multilevel healthcare in the metropolis of Chengdu, China: a new assessment approach","volume":"16","author":"Zhang ShaoYao","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"B24","doi-asserted-by":"publisher","first-page":"115458","DOI":"10.1016\/j.socscimed.2022.115458","article-title":"Inequalities of spatial primary healthcare accessibility in China","volume":"314","author":"Jia","year":"2022","journal-title":"Soc Sci Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.05.023","article-title":"Spatial accessibility of primary health care in China: a case study in Sichuan Province","author":"Wang XiuLi","year":"2018","journal-title":"Soc Sci Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1080\/08946566.2019.1652718","article-title":"Perceptions of elder abuse and neglect by older Chinese immigrants in Canada","volume":"31","author":"Zhang","year":"2019","journal-title":"J Elder Abuse"},{"key":"B27","doi-asserted-by":"publisher","first-page":"14656","DOI":"10.3390\/ijerph192214656","article-title":"Research on the equity and optimal allocation of basic medical services in Guangzhou in the context of COVID-19","volume":"19","author":"Li","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S1353-8292(02)00067-9","article-title":"Using a GIS-based floating catchment method to assess areas with shortage of physicians","volume":"10","author":"Luo","year":"2004","journal-title":"Health Place"},{"key":"B29","doi-asserted-by":"publisher","first-page":"101745","DOI":"10.1016\/j.compenvurbsys.2021.101745","article-title":"Equalizing the spatial accessibility of emergency medical services in Shanghai: A trade-off perspective","volume":"92","author":"Li","year":"2022","journal-title":"Comput Environ Urban Syst"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.healthplace.2010.06.012","article-title":"Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit","volume":"16","author":"Dai","year":"2010","journal-title":"Health Place"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtrangeo.2017.11.009","article-title":"Urban green space accessibility changes in a high-density city: a case study of Macau from 2010 to 2015","author":"Ye","year":"2018","journal-title":"J Transp Geog"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1080\/13658816.2019.1591415","article-title":"A comparative analysis of accessibility measures by the two-step floating catchment area (2SFCA) method","volume":"33","author":"Chen","year":"2019","journal-title":"Int J Geogr Inf Sci"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1177\/2399808318755145","article-title":"Modelling the spatial accessibility of the elderly to healthcare services in Beijing, China","volume":"46","author":"Tao","year":"2019","journal-title":"Environ Plan B Urban Anal City Sci"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.3390\/ijerph15071503","article-title":"Use of an E2SFCA Method to Measure and Analyse Spatial Accessibility to Medical Services for Elderly People in Wuhan, China","volume":"15","author":"Luo","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1038\/s41598-024-51805-1","article-title":"A study on matching supply and demand of ecosystem services in the Hexi region of China based on multi-source data","volume":"14","author":"Zhang","year":"2024","journal-title":"Sci Rep"},{"key":"B36","doi-asserted-by":"publisher","first-page":"7606","DOI":"10.3390\/su17177606","article-title":"Multi-Dimensional Accessibility Framework for Nursing Home Planning: Insights from Kunming, China","volume":"17","author":"Ding","year":"2025","journal-title":"Sustainability"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1700098","DOI":"10.3389\/fpubh.2025.1700098","article-title":"Healthcare inequities in Chinese megacities: the older adult population's accessibility to public hospitals in suburban Shanghai","volume":"13","author":"Wang","year":"2025","journal-title":"Front Public Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"105998","DOI":"10.1016\/j.scs.2024.105998","article-title":"Exploring the equitable spatial planning on the accessibility of institutional elderly care in megacity: a study based on Chengdu, China","volume":"117","author":"Mingyang","year":"2024","journal-title":"Sustain Cities Soc"},{"key":"B39","doi-asserted-by":"publisher","first-page":"4601","DOI":"10.3390\/app15094601","article-title":"Deep Learning-Driven Geospatial Modeling of Elderly Care Accessibility: Disparities Across the Urban-Rural Continuum in Central China","volume":"15","author":"Yu","year":"2025","journal-title":"Applied Sciences"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1775866","DOI":"10.3389\/fpubh.2026.1775866","article-title":"A study on the equilibrium of older adult care service resources and demand in Guangzhou","volume":"14","author":"Liu","year":"2026","journal-title":"Front Public Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1890540\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:33Z","timestamp":1783916613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1890540\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":40,"alternative-id":["10.3389\/fpubh.2026.1890540"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1890540","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"article-number":"1890540"}}