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Assessing spatial accessibility of rabies post-exposure prophylaxis clinics in Gansu Province, China
Shuyu Liu1, Na Jin1, Xuefeng Liang1
1Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu Province, China.
Objective:
To understand the current status of rabies post-exposure prophylaxis (PEP) clinic construction in Gansu Province and analyze the distribution of rabies PEP clinics across the province. To evaluate residents' geographic accessibility to rabies PEP clinics, to provide a sound basis for the rational allocation of medical resources related to rabies PEP.
Methods:
Address information and service type data of rabies PEP clinics in Gansu Province in 2024 were collected. The number and kernel density of clinics were calculated by different areas and different services provided by clinics. Combined the road network, land cover, elevation, inland water body data downloaded from websites, and cost distance model in ArcGIS software was used to calculate the accumulated traffic-cost score for residents reaching the nearest rabies PEP clinic by different areas.
Results:
In 2024, Gansu Province had a total of 426 rabies PEP vaccination clinics. Among these, 69.72% provided wound management services, while 19.01% offered passive immunizing agents. Regional disparities were observed across different administrative and economic levels. In terms of spatial distribution, clinic density was highest in eastern regions, whereas western regions exhibited significantly lower density. Spatial analysis revealed that rabies PEP clinics in Gansu Province exhibited significant clustering characteristics, with a nearest neighbor ratio (NNR) of 0.490 (Z = -20.117, p < 0.05). Transportation accessibility assessment indicated that certain western and southern regions of Gansu Province had higher travel cost scores compared to other areas.
Conclusion:
Through analysis of the basic status of rabies exposure clinics in Gansu Province, combined with kernel density and transportation cost-distance analyses, reveals shortcomings in the standardized construction of rabies PEP clinics in the province. It is recommended to rationally plan clinic layouts, strengthen the service capacity building of clinics in economically underdeveloped and transportation-inconvenient areas, and enhance overall service capabilities.
