Impacts Of Urban Built Environment On The Medical Travel Behavior Of "Migratory Bird" Elderly Population

With the intensification of population aging and the era development,The elderly care is breaking through the traditional family care approaches,the migratory elderly care approach is favored by more and more seniors.Based on statistics,There were 1.64 million migratory elderly people in Hainan province from October 1^st,2017 to April 30^th,2018,accounting for17%of the local residents,and they have become a group that cannot be ignored.The migratory elderly people have greatly promoted the development of Hainan’s economy,society and culture,but the seasonal influx of a large number of migratory elderly people has increased the burden on medical service facilities and road transportation infrastructure,causing traffic congestion,shortage of medical resources and other issues,and caused a seasonal impact on local public services.Traveling for medical care is closely related to residents’happiness,and also influences the allocation of public transportation and medical resources.A large number of studies have shown that residents’travel behavior was directly affected by the urban built environment.Therefore,this research studies the medical travel behavior of the migratory elderly people from the perspective of urban built environment,and provides new ideas to solve the medical dilemma faced by the migratory elderly people while further improving the research on travel for medical treatment in China.As the preferred destination for the elderly to migrate in winter,Sanya City is facing the problem of seasonal increase in the pressure of public services such as medical services and transportation services due to the influx of migratory elderly people in a short period of time.In the context of the construction of free trade port,Chinese modernization and common prosperity,and at the key point of the transformation of Sanya from traditional service industry to modern high-end service industry,how to deal with the challenges brought by the migratory elderly people and effectively resolve the contradiction between supply and demand of public medical services in the city is an important issue that the government needs to consider carefully and must solve.Taking Sanya city as the study area,analyzing the mismatch between the migratory elderly people and medical resources in Sanya city,establishing the urban built environment measurement system based on the"7D"built environment analysis framework,and combining the data from the 2022 Sanya migratory elderly people medical travel questionnaire,the study analyzed the effects of urban built environment variables on the medical travel behavior of migratory elderly people in Sanya City by using multinomial logistic regression model and binary logistic regression model in two contexts:emergency medical care and non-emergency medical care.The findings of the study are as follows:（1）There is an obvious spatial mismatch between the migratory elderly people and medical resources.The spatial mismatch between migratory elderly people and medical resources is more serious than the spatial mismatch between the residents and medical resources in the metropolitan area.In terms of space,the spatial mismatch between migratory elderly people and medical resources is mainly reflected in the Sanya Bay area,where a large number of migratory elderly people gather,but the quantity and quality of medical facilities are both at a low level.（2）The spatial clustering and distribution characteristics of urban built environment elements in Sanya are obvious,and the personal socio-economic attributes of the migratory elderly people have typical characteristics that are different from those of the local residents.The population density,the number of parking lots,the accessibility of non-emergency medical care and the accessibility of emergency medical care in the metropolitan area show obvious spatial characteristics of clustering in the city center;the road network density,the land-use mixed index and the accessibility of public transportation are relatively well distributed in the central city.From the questionnaire data,it can be seen that the migratory elderly people have obvious characteristics such as better economic conditions,higher education and more likely to be civil servants.（3）There were significant differences in the medical travel behavior of migratory elderly people in different medical care contexts.In the non-emergency medical care situation,the main medical travel mode of migratory elderly is slow travel,followed by car travel,and the main medical destination is clinic,followed by general hospital;in the emergency medical care situation,the medical travel mode of migratory elderly people is mainly car travel,and the main medical travel destination is general hospital.（4）In the non-emergency medical care situation,the built environment had a significant effect on the medical travel behavior of migratory elderly people.The results showed that population density and accessibility of non-emergency care had significant effects on the choice of travel mode,built environment had significant effects on the choice of travel destination,and population density had significant effects on travel time.Among them,population density has a significant effect on the choice of travel mode,travel destination and travel time of migratory elderly,which profoundly affects the non-emergency travel behavior of migratory elderly people.（5）In the emergency medical care,situation,the built environment has limited influence on the medical travel behavior of migratory elderly people.The analysis found that the accessibility of emergency medical treatment had a significant effect on the choice of medical treatment travel mode;the built environment had no significant effect on the choice of medical treatment travel destination;the population density and accessibility of emergency medical treatment had a significant effect on the travel time of medical treatment.In general,the travel behavior of migratory elderly people is mainly influenced by the accessibility of emergency medical treatment in the emergency medical treatment situation.Based on the main findings,this research proposes policy recommendations for urban spatial planning,medical resource deployment,and traffic management optimization from the perspectives of improving the medical travel experience of migratory elderly people,alleviating seasonal medical service pressure,and improving seasonal traffic congestion.