Spatial optimisation strategies for tertiary hospitals to promote health equity in Tianjin, China

The layout of healthcare facilities is an important factor influencing urban health equity, which is, in turn, of great significance for sustainable urban development. To improve the equity of healthcare facilities, the nearest neighbor analysis method was employed to identify the spatial distribution pattern of tertiary hospitals in Tianjin, while kernel density analysis was used to calculate their spatial distribution. The population distribution within Tianjin’s built-up area was estimated using the thermal map of residential POI data and the scope of built area. The service capacity and referral efficiency of tertiary hospitals in Tianjin were assessed using the network analysis method. The results indicate that the distribution of tertiary hospitals in Tianjin is clustered, with a strong concentration in the central city. The service capacity and referral efficiency of tertiary hospitals in these central urban areas are higher than those in peripheral administrative regions. It is recommended to increase the number of tertiary hospital beds in areas with insufficient bed capacity and to establish new tertiary hospitals in underserved areas. These measures aim to enhance the balance in spatial distribution, service capacity, and referral efficiency of tertiary hospitals.