How does the spatial accessibility of medical resources change during a public health crisis? A perspective based on residents' healthcare preferences

The spatial accessibility of medical resources as a foundation for urban responses to public health crises, directly affects public health and social equity, and has become a key consideration in the post-pandemic era. Previous research has focused more on the spatial attributes of medical resources, neglecting residents' medical preferences, while residents' choices directly affect the allocation of medical resources. Therefore, it is necessary to explore the spatial accessibility of medical resources based on residents' preferences during public health crises. This manuscript uses discrete choice experiment (DCE) to determine the changes in medical preferences of residents in Wuhan, China during the pandemic. On this basis, an improved two-step floating catchment area method (2SFCA) is employed for assessing the spatial accessibility of medical resources. The results show that: (1) Changes in residents' medical preferences guide the spatial allocation of urban medical resources. (2) After the outbreak of a public health crisis, the importance of hospital level, travel time, and medical expenses for residents decreased, while the importance of queuing time increased. (3) The observed change of residents' preference for medical treatment activated idle medical resources and improved their spatial accessibility overall. However, differences in the initial endowment of medical resources resulted in larger regional differences in spatial accessibility and intensified the inequality of medical services. This manuscript argues that considering residents' preferences can provide a more accurate understanding of changes in the spatial accessibility of medical resources, offering important insights for optimizing resource allocation and effectively responding to future unexpected crises. • A preference view is used to study the spatial accessibility of medical resources. • An improved two-step floating catchment area is proposed. • The spatial accessibility of medical resources is effectively measured. • Changing preferences cause changes in spatial accessibility of medical resources. • The datasets used and/or analyzed during the current study are available from the corre-sponding author on reasonable request.