Luo Weicong, Zhu Yuanyuan, Yang Zihan, Wang Fei, Wang Yue
College of Public Administration, Huazhong Agricultural University, Wuhan, 430070, China.
Key Laboratory of Geographic Process Analysis & Simulation Hubei Province, Central China Normal University, Wuhan, 430079, China.
Int J Health Geogr. 2025 Jul 22;24(1):16. doi: 10.1186/s12942-025-00406-w.
As urbanization accelerates, the height of urban buildings continues to rise, which may influence the provision of Emergency Medical Services (EMS). However, a current limitation is that related studies often neglect the impact of spatial variations in building height on EMS accessibility equality. Most scholars have focused primarily on EMS road travel-either the Departure Road Trip (DRT) or the Transport Trip (TT)-while overlooking the effects of building height on the in-building EMS trip, known as the Patient Access Trip (PAT).
EMS accessibility was measured using a proximity-based method and a Gaussian two-step floating catchment area (G-2SFCA) model under two scenarios: Scenario 1 considered only DRT, whereas Scenario 2 incorporated both DRT and PAT influenced by building heights. DRT travel times were simulated using Baidu Map's Application Programming Interface (API), and PAT times were calculated based on building elevator/stairs characteristics. Accessibility equality was assessed using multi-ring buffer analysis, Lorenz curves, and Gini coefficients.
According to the empirical study in Wuhan, China, first, the spatial variations in building height was evident across the city. The building heights in city centre and sub-centres are generally taller compared to those in suburban areas. Second, the variations in building height can obviously affect EMS accessibility. However, the impact of building height on EMS accessibility varies across different regions. The effect is particularly pronounced in sub-centres located around 14 km from the city centre, whereas it is relatively limited in suburban areas. Third, the incorporation of spatial disparities in building height into EMS accessibility modeling reveals increased inequality in EMS provision across the city.
Spatial disparities in building heights across a city significantly influence EMS accessibility inequality. Given the widespread differences in building heights worldwide, this study provides valuable findings for healthcare policymakers to improve EMS systems.
随着城市化进程加快，城市建筑高度不断攀升，这可能会对紧急医疗服务（EMS）的提供产生影响。然而，目前的一个局限性在于，相关研究往往忽视了建筑高度的空间差异对EMS可达性公平性的影响。大多数学者主要关注EMS的道路行程，即出发道路行程（DRT）或运输行程（TT），而忽略了建筑高度对楼内EMS行程（即患者接入行程，PAT）的影响。
在两种情景下，使用基于邻近度的方法和高斯两步浮动集水区（G - 2SFCA）模型来衡量EMS可达性：情景1仅考虑DRT，而情景2则纳入了受建筑高度影响的DRT和PAT。使用百度地图的应用程序编程接口（API）模拟DRT行程时间，并根据建筑电梯/楼梯特征计算PAT时间。使用多环缓冲区分析、洛伦兹曲线和基尼系数评估可达性公平性。
根据中国武汉的实证研究，首先，全市建筑高度的空间差异明显。市中心和次中心的建筑高度通常比郊区的更高。其次，建筑高度的变化会明显影响EMS可达性。然而，建筑高度对EMS可达性的影响在不同区域有所不同。在距离市中心约14公里的次中心，这种影响尤为明显，而在郊区则相对有限。第三，将建筑高度的空间差异纳入EMS可达性建模显示，全市EMS服务的不平等性增加。
城市建筑高度的空间差异显著影响EMS可达性的不平等。鉴于全球建筑高度存在广泛差异，本研究为医疗政策制定者改进EMS系统提供了有价值的发现。
