Spatial Distribution Evaluation and Optimization of Medical Resource Systems in High-Density Cities: A Case Study of Macau via GIS and Space Syntax Analysis

As a typical example of a high-density city, Macau’s medical resource allocation system, a key component of the city’s complex socio-technical system, suffers from significant spatial imbalances, which restricts the overall effectiveness of the medical service system. Based on the perspective of systems science theory, regards the allocation of medical resources as a dynamic system with multiple coupled factors. It comprehensively utilizes systems research methods such as POI data mining and space syntax analysis and employs techniques such as kernel density analysis and spatial structure coupling models to systematically evaluate the spatial structure, resource accessibility, and service balance of Macau’s medical service system. It found that (1) the Macau Peninsula has concentrated core medical resources, such as the Conde de São Januário Hospital (CHCSJ) and Kiang Wu Hospital, which form a core subsystem with high service saturation. Excessive concentration of resources has led to high concentration of a certain type of facility. (2) Taipa Island and the Cotai Reclamation Area have created an extended subsystem of medical resources along with urban development. However, the northern area does not have enough facilities, and its internal structure is not balanced. (3) Coloane Island has only basic health stations remaining, forming a marginal subsystem with scarce medical resources, which has a significant hierarchical gap with the core and extended subsystems. This spatial pattern of “saturated Macau peninsula, expanded Taipa Island, and sparse Coloane Island” is essentially a concrete manifestation of the imbalance between the medical resource allocation system and the urban spatial development system. Therefore, based on system optimization theory, it proposes constructing a multi-level, networked spatial system for medical facilities to promote the coordinated operation of various regional medical subsystems and achieve overall functional optimization and a balanced layout for Macau’s medical service system. This research analyzes the imbalance mechanism of high-density urban public service systems using systems science methods, providing not only a scientific basis for the precise optimization of Macau’s medical resource allocation system but also a practical reference for the planning and governance of similar high-density urban public service systems under a systems thinking framework.