Assessing elderly's perceived accessibility of community hospitals from a satisfaction perspective in China's Beijing metropolis

Objectives: Ensuring healthy aging is common goal of healthcare equity endeavors vis-à-vis the aging population. Spatial accessibility of medical facilities can be studied in tandem with users’ perceived accessibility, especially for elderly people (> 60 years) with mobility and health limitations. Understanding perceived accessibility of community hospitals can identify key determinants and improve service. 

Methods: This study selected four districts on a city-core to suburbs urbanization gradient to represent Beijing's four functional areas. An indicator system was established based on questionnaire interviews and statistical analyses to evaluate perceived accessibility. An importance-performance analysis detected low-accessibility factors deserving improvements. 

Results: The results yielded higher perceived accessibility in Dongcheng and Shunyi than in Chaoyang and Miyun. Elderly respondents accorded higher scores to dimensions of spatial pattern, service condition, and service facility than service quality. A shorter distance to hospitals solicited better satisfaction with various medical services. Concerns about service quality and medical fee demanded more attention. 

Conclusions: The uneven resources, elderly care pattern and service quality distributed in Beijing proposed tiered drug supply, multi-site practice, and telemedicine for systematic improvement of community hospitals to enhance elderly's perceived accessibility. The findings can inform measures to enhance the quality and attractiveness of community-hospital services to elderly residents, raise their satisfaction and willingness to seek medical care, and overcome their obstacles to health-seeking behavior. These changes can increase fairness and efficiency in delivering health care to the aging population. 

Public Interest Summary: As cities age, ensuring fair access to healthcare for older adults is crucial. This study examined how seniors (60+) in Beijing perceive the ease of reaching and using community hospitals, which can influence their willingness to seek care. Researchers compared four districts—from central to suburban areas—and found that while location (shorter distance) improved satisfaction, concerns about service quality and costs remained key barriers. Older adults cared most about convenient locations, available facilities, and basic services rather than advanced medical quality. The findings suggest that improving local hospitals’ affordability, staff attitudes, and service efficiency could encourage more seniors to use them, reducing healthcare inequalities. These changes would help create a more accessible and equitable system for aging populations in cities like Beijing—and similar urban areas worldwide. Copyright © 2025 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.