| 摘要: |
| 就医出行是残障群体的刚需出行，
无障碍环境的缺失不仅剥夺了其平等获取医
疗资源的机会，更加剧了其健康脆弱性与社
会边缘化风险。基于2 601 份北京市下肢障
碍者就医出行问卷与无障碍医疗设施及无障
碍公交站点空间数据，构建“出行行为识别
—空间覆盖评估—影响机制分析”的分析框
架，探讨其就医出行特征与影响因素。结果
表明，下肢障碍群体就医出行具有高刚性和
中长距离特征，受年龄、残障程度等个体因
素及出行方式偏好显著影响，且频率与距离
存在明显城郊差异。空间分析显示，北京市
无障碍公共医疗设施分布呈“中心—边缘”
格局，四环以外公交站点与医疗设施衔接不
足，导致郊区群体出行受限。回归检验进一
步验证了个体与环境因素对下肢障碍群体就
医出行的复杂作用机制，显示出设施空间布
局和公共交通衔接的重要性。建议优化基层
医疗设施供给，完善“公共交通—医疗机
构”衔接，缩小城郊医疗服务可达性差距。 |
| 关键词: 下肢障碍群体 就医出行行为 无
障碍环境 医疗服务设施 影响机制 设施
规划 |
| DOI：10.13791/j.cnki.hsfwest.20250815002 |
| 分类号: |
| 基金项目:国家社科基金重大项目（22&ZD186） |
|
| Healthcare travel behavior and its determinants among people with lower limb disabilitiesin Beijing |
|
HOU Yuting,GAO Mengzhao,SHAO Lei
|
| Abstract: |
| Healthcare-related travel represents a highly rigid and indispensable form of mobility for
people with disabilities. For individuals with lower limb disabilities in particular, inadequate barrierfree
environments not only constrain their physical mobility but also systematically restrict their
ability to access essential medical services, thereby intensifying health vulnerability and reinforcing
spatially embedded social inequality. In rapidly urbanizing megacities such as Beijing, where
medical resources and accessible infrastructure remain unevenly distributed, healthcare travel
provides a critical lens through which to examine the interaction between individual mobility
capacity and the spatial organization of public services.This study investigates the healthcare travel
behavior of people with lower limb disabilities in Beijing and examines the mechanisms through
which individual characteristics and the built environment jointly shape travel frequency and spatial
reach. Drawing on a dataset of 2 601 valid questionnaires collected across all 16 administrative
districts of Beijing, combined with spatial data on barrier-free public medical facilities and
accessible bus stops, the study develops an integrated analytical framework of “travel behavior
identification-spatial coverage assessment-impact mechanism analysis”. Grounded in spatial
behavior theory, this framework conceptualizes healthcare travel as a demand-driven yet constraintsensitive
activity influenced by both personal attributes and environmental conditions. At the
behavioral level, descriptive and comparative analyses reveal that healthcare travel among people
with lower limb disabilities exhibits pronounced rigidity and a predominance of medium-to-longdistance
trips, frequently exceeding the conventional service radius of the “15-minute city”. Travel
frequency and distance do not follow a simple linear relationship, indicating that healthcare travel
cannot be adequately explained by proximity alone. Individual characteristics exert differentiated
and non-linear effects. Age is positively associated with healthcare travel frequency, reflecting
increasing health needs over the life course. Disability severity demonstrates a dual mechanism:
while more severe impairments generate greater medical demand, they simultaneously impose
stronger mobility constraints, resulting in heterogeneous behavioral outcomes rather than a
monotonic decline in travel activity.Travel mode choice further mediates healthcare travel behavior.
Public transport, particularly buses, constitutes the primary mode for low- and medium-frequency
healthcare trips, while high-frequency travelers tend to rely more on walking or disability-specific
mobility devices to ensure reliability. Survey responses also reveal persistent dissatisfaction with
bus stop accessibility, particularly regarding distance from both residences and medical
destinations, suggesting latent spatial barriers even where public transport infrastructure formally
exists. Spatial analysis of barrier-free public medical facilities demonstrates a clear “centerperiphery”
pattern. High-density, well-distributed facilities are concentrated within the central
urban area, while suburban and peripheral districts remain comparatively underserved, with
facilities clustered around administrative centers and large population nodes. Accessible bus stops
exhibit a contrasting pattern of “networked cores and isolated peripheries”: while inner-city areas
benefit from continuous coverage, suburban districts often display fragmented or island-likedistributions with weak interconnectivity. Overlay analysis further reveals insufficient spatial integration between medical facilities and accessible bus stops
beyond the Fourth Ring Road, significantly undermining effective accessibility for suburban residents.To examine the combined effects of individual and
spatial factors, the study employs a generalized ordered logistic regression model with healthcare travel frequency as the dependent variable. The results
confirm that healthcare travel behavior is shaped by the joint influence of personal attributes and environmental conditions. Age and disability severity
remain significant predictors, but their effects vary across frequency thresholds, underscoring the importance of accounting for behavioral heterogeneity.
Contrary to expectations, the overall coverage rate of barrier-free medical facilities does not exert a statistically significant effect, suggesting that once a
basic supply threshold is reached, the quantity of facilities alone is insufficient to promote healthcare travel. In contrast, the coverage of accessible bus stops
significantly increases the likelihood of transitioning from low-frequency to medium- or high-frequency healthcare travel, highlighting the critical role of
public transport connectivity in enabling mobility. Residential location emerges as a key structural constraint. Living in suburban districts significantly
reduces the probability of high-frequency healthcare travel, even after controlling for individual characteristics and facility coverage. This finding indicates
that urban-suburban disparities in accessibility operate through spatial mismatches between healthcare resources and transport infrastructure, systematically
suppressing healthcare mobility among suburban residents with lower limb disabilities.Based on these findings, the study argues that policy priorities should
shift from expanding the number of barrier-free facilities to optimizing their spatial configuration and functional integration. Recommendations include
strengthening the service capacity and accessibility of primary medical facilities in areas with high concentrations of elderly and disabled populations;
improving the physical and functional integration between public transport systems and medical institutions, particularly in suburban areas; and reducing
urban–suburban disparities in healthcare accessibility through coordinated transport and facility planning. By linking individual healthcare travel behavior
with spatial accessibility at the metropolitan scale, this study contributes to disability-inclusive mobility research and provides empirical evidence to support
more equitable healthcare and transport governance in megacities. |
| Key words: people with lower limb disabilities healthcare travel behavior accessible environment medical facilities determinants facilities pla |
