Abstract
The accessibility of medical service facilities is a vital influence on elderly people choosing medical treatment. Encouraging residents to seek nearby medical treatment can facilitate the rational layout and diversion of urban medical facilities and reduce health resource waste. However, due to accessibility factors, elderly people may not choose the nearest hospital. In order to investigate such factors, we conducted a questionnaire survey among the elderly from 10 tertiary general hospitals in Hefei, China. On the basis of the origin-destination (OD) cost matrix analysis and statistical analysis of 830 valid questionnaires, this paper analyzed the elders' selection rules when choosing medical facilities and the factors considered when making a choice. The study found that although 85% of elderly participants valued a short distance to tertiary hospitals, only 31% of them attended the closest hospitals in reality, which correlated with regularity according to their education level, travel activity status, and place of residence. The elderly highlighted road congestion, convenience of public transport stations, and number of transfers as critical in determining whether they sought nearby medical treatment. According to the results, effective ways to encourage the elderly to attend their nearest hospital, from the perspective of accessibility, include easing road congestion, improving the layout of public transport stations, and optimizing urban public transport routes. In particular, when planning future medical facilities, attention should be paid to the elderly with primary school education or below, who cannot travel independently, and those who live far from the city center.