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Improving the Spatial Accessibility of Community-Level Healthcare Service toward the '15-Minute City' Goal in China

Background: The recent global COVID-19 pandemic serves as another reminder that people in different urban neighborhoods need equal access to basic medical services. This study aims to improve the spatial accessibility of healthcare services toward the ‘15-minute city’ goal. Methods: We chose Zhengzhou, China, as a case study. To improve spatial accessibility, two optimization models of optimal supply-demand allocation (OSD) and the capacitated p-medina problem (CPMP) were used. Spatial accessibility in this study is defined as the walking time from the communities to healthcare centers. Results: For the current status of healthcare services at the community level, the mean travel time is 18.3 min, and 39.6% of residents can access healthcare services within a 15-minute travel time. Population coverage within a 15-minute walking time is significantly lower than the national target of 80%. After redefining the service areas through OSD allocation, the mean travel time was reduced to 16.5 min, and 45.1% of the population could reach services. Furthermore, the 60 newly proposed healthcare centers selected by the CPMP model could potentially increase by 35.0% additional population coverage. The average travel time was reduced to 10 min. Conclusions: Both the redefinition of the service areas and the opening of new service centers are effective ways to improve the spatial accessibility of healthcare services. Two methods of this study have implications for urban planning practices towards the 15-minute city.