Equity vs. Efficiency: A Spatial Analysis of Residential Aged Care Resources in Beijing
BI Xiangyang, LI Mo
2020, 40(3):
117-147.
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Based on the data collected from residential aged care facilities(RACFs)websites and the Sixth National Census,this paper examines the spatial pattern of residential aged care resources in Beijing under the framework of spatial location theory of public facilities,addressing issues such as spatial inequality,spatial clustering,spatial accessibility and spatial regression analysis. Due to the unique distribution characteristics of township/neighborhood residential aged care resources,this study carries out the Bayesian analysis of public and private aged care resources distribution by using both the zero-inflated negative binomial distribution SLM(Spatial Lag Model)and BYM(Besag,York and Mollié) models in R-INLA. The results show that,at the township/neighborhood level,the overall distribution of public aged care resources is quite balanced as a whole,affected by regional homogenization of administrative power or the equalization of public services. Resource distribution shows a positive spatial dependence and remains stable even after population factor control. Excluding population factors,the ρ value (spatial autoregressive coefficient) of private aged care resources exceeds that of public. However,with the inclusion of population factors,though not statistically significant,the ρ value changes from positive to negative,showing negative spatial correlation. The results of spatial regression analysis also show that although both public and private distribution patterns are affected by the absolute number of targeted service population in the jurisdiction,the distribution of private old-age resources is more sensitive to the density index of the local elderly population,and the spatial layout is more determined by the target population or other related factors. For the public old-age resources,the spatial layout is largely determined by the administrative factors. Even though the overall trend is to be balanced and fair,some localities have failed to effectively make targeted adjustments according to the needs of population in different locations,resulting in a dualistic structure of insufficient utilization of nursing beds in suburb and shortage of supply in inner city. By contrast,the private sector distributes resources more in tune with the intensity index of the target population but on the whole the service is unbalanced. In short,the spatial resource distribution pattern of public and private ownerships reflects the contrast between efficiency and equity in providing aging care in China,a fact that is being shaped by both administrative and market forces.