Enhancing elderly care services in high-density aging communities: a dual-dimensional GIS-SPO framework for spatial and temporal optimization

Amid rapid population ageing, integrating health and social care in high-density urban neighbourhoods remains a critical challenge. We propose a dual-dimensional “spatio-temporal efficiency–service perception” framework combining GIS with the Structure-Process-Outcome (SPO) model, and tested it in Sanqiao Sub-district, Wuhan, China. Barrier-free renovations increased 15-minute elderly care coverage from 71.5% to 86.2%. Regression analysis identified facility adequacy (β = 0.22) and staff empathy (β = 0.14) as key satisfaction drivers. However, non-spatial barriers persisted: counselling utilisation was only 47.2%, and care costs ≥ 22% of household income reduced uptake by 63%. The “renovation + micro-station” strategy achieved 95.8% policy compliance, 100% EHR interoperability, and cut service response time to < 10 min. The model offers a culturally adaptive, transferable blueprint for resource-constrained ageing cities, emphasising that spatial fixes must be coupled with financial and stigma-reduction interventions to achieve equitable care access.