1. Introduction
During the rapid urbanization of China over the last 20 years, the socioeconomic level and living standards of residents have developed significantly. However, public service facilities still need improvement. The large population and construction scale of megacities have led to many ‘urban diseases’, such as urban traffic congestion and unequal resource distribution. The further development of Chinese cities must transition from quantity accumulation to quality improvement. Functional improvement and allocation optimization of public service facilities have become the primary tasks for the development of megacities in China in the new era. The optimal allocation of public service facilities is an important way to realize social fairness and justice, because it balances the spatial distribution between different regions and satisfies the demands of different groups in their daily lives. In this generation, residents with different social backgrounds should have relatively fair access to balanced facility services considering the various population densities in different regions. Therefore, the most important task is to reasonably assess existing public service facilities.
In 1963, Cooper studied the location of industrial spaces and the location–allocation model of public service facilities, which initiated research in this field. Current research focuses on the three aspects of public service facility allocation [
1,
2,
3,
4], the spatial structure of facility allocation [
5,
6,
7,
8], and facility accessibility [
9,
10,
11,
12]. Many spatial models have also been proposed to continue empirical research on facility allocation evaluation, such as (1) the minimum distance model [
13,
14,
15,
16,
17], (2) the maximum coverage model [
18], (3) the gravity model [
19], and (4) the improved gravity model [
20]. In general, existing research that measures the quality of facilities based on spatial allocation has two flaws. First, service quality evaluation elements are inadequate; the researches only focus on the perspective of facility hardware and accessibility measurement, ignoring the subjective feelings of residents such as usage intensity, frequency, and satisfaction. Second, against the developmental background of rapid population migration, static index data cannot effectively reveal actual resident usage efficiency of public service facilities after allocation. Furthermore, reflecting the network connections among facilities and radiation effects on surrounding areas is also difficult.
Research on the evaluation of urban public service facilities has mainly been conducted from the following three aspects: supply, demand, and supply–demand matching. The evaluation based on the supply dimension mainly relies on building indicator data such as facility level, scale, and performance to evaluate service fairness, accessibility, equalization, regional differentiation, and related planning and configuration strategies [
21]. The research methods include kernel density analysis [
22], cluster analysis [
23], reachability analysis [
24], etc. The evaluation based on the demand dimension mainly uses methods such as satisfaction surveys, facility usage frequency surveys, and walking tolerance time surveys [
25] to study the needs of different age, gender, and occupational groups [
26] for facilities. The evaluation based on the supply–demand matching dimension is based on different scale spaces, combining objective evaluation of facilities with subjective feelings, and exploring the matching relationship between facility accessibility and regional population size. However, the existing standards for the configuration of public service facilities lack precise descriptions of facility types and supply–demand matching relationships, and the evaluation results reflect differences in the subjective cognitive level of researchers [
27]. In addition, existing evaluation methods are limited by various factors such as facility spatial layout, service scope, and personalized needs of residents, and a systematic evaluation system has not yet been provided [
28].
Satisfaction is a type of mental state and facility satisfaction is the quantitative assessment of residents’ psychological feelings about the facilities’ service quality through an evaluation index system. Currently, satisfaction research in the field of geography and planning focuses primarily on community spaces and public service facilities. The researchers obtained data mostly from questionnaire surveys and household interviews. An index system was built to explore specific satisfaction factors from the perspectives of spatial location, accessibility, and facility quality [
29,
30,
31,
32]. Traditional questionnaires and interviews have many shortcomings such as long research cycles, high labour costs, and limited sample sizes and coverage. Based on smart cities and mobile social networks, the activity data of large-scale residents can be effectively identified and collected. These types of data contain more elaborate spatiotemporal information, and rich activity attributes information that covers a large population. Activity data can effectively reflect the usage intensity and frequency between residents and facilities. It also provides a new research perspective and data source for studying urban public service facilities [
33,
34,
35,
36].
Previous studies have suggested that the impact of a living space environment on satisfaction includes the following two levels: spatial attributes and non-spatial attributes. The spatial attributes include the differentiation characteristics of community location and living space [
35], urban built environment [
37], resource allocation and accessibility [
33], and other aspects. Meanwhile the non-spatial attributes mainly include the socioeconomic attributes of residents, community type [
37], social capital [
38], technological updates [
38], and characteristics of resident groups [
38], all of which have a strong impact on resident satisfaction [
39]. From the perspective of spatial elements, various types of public service facilities constitute the core content affecting resident satisfaction. Previous studies have explored the impact of basic public service facility configuration on resident satisfaction [
38], confirming the direct impact of objective environmental attributes and elements around residential areas on resident satisfaction. Taking medical service facilities as an example, research has found that the transportation accessibility [
32], facility scale [
33], service quality [
33], and other attributes of facilities have a significant direct or indirect positive impact on resident satisfaction. From the perspective of non-spatial attributes, there is significant heterogeneity in the relationship between individual socioeconomic attributes and satisfaction among residents. Different attributes such as age, family income, education level, migration situation, and nature of daily work may all have an impact, and these factors are usually included as controlling factors in the satisfaction evaluation model. There are significant differences in the element system, degree of influence, and mechanism of action among different scenarios [
35]. Some studies suggest that there is an indirect impact between subjective resident perception and expectations, which is controlled by individual differences [
35]. Community communication has also been proven to have a significant positive impact on resident satisfaction [
36]. Based on the perceived objects of residents, research has confirmed the mediating effect of subjective perception in the living system. Satisfaction is often decomposed into the following three aspects: environmental satisfaction, facility satisfaction, and social satisfaction [
36]. These are then specifically decomposed into multiple dimensions of perceived content such as safety satisfaction, comfort satisfaction, convenience satisfaction, and community belonging [
39].
Overall, safety and convenience are the basic needs that residents are satisfied with in the living environment [
31], and these are directly influenced by the opportunities for material space access and the level of material space construction. Comfort and aesthetics are the satisfaction needs of higher-level residents, which are not only directly influenced by the elements of the living system, but also by the comprehensive influence of social attribute factors. The subjective satisfaction indicators and their mechanisms of action in the four dimensions have been partially confirmed, but the influencing pathways need to be further clarified [
33]. There are two shortcomings in the research on the impact mechanism of existing resident satisfaction with public service facilities. First, the selection of facility types and levels is not comprehensive enough, and the definition of evaluation dimensions is not clear. Research mainly focuses on the accessibility indicators of facilities, while there is relatively little research on the satisfaction impact mechanism of comprehensive aspects such as facility scale supply, functional connotation, and service quality, thus making it difficult to propose targeted facility optimization and improvement strategies [
38]. Second, due to the lack of targeted research theories and methodological frameworks, the mechanism and impact path of facility factor satisfaction in this study are not yet clear, and the correlation between various dimensional elements is difficult to quantify; in particular, the research on the interaction relationship between safety, convenience, comfort, and aesthetic perception systems is not sufficiently in-depth [
39]. This article focuses on two issues, one of which is to analyse whether the supply and demand of medical resources have reached a balance in various towns and districts of Nanjing City, and if not, to determine what specific supply–demand contradictions exist. The second is to analyse which factors affect the satisfaction index of medical facility services, and to identify the specific mechanism of action. Based on existing evaluation methods for public service facilities, this study proposes a new method to evaluate public service facilities from the perspective of residents’ activities. We built an index system from the aspects of usage quality and evaluation to quantitatively measure residents’ satisfaction based on microblog check-in data and online comments context. Subsequently, we used medical facilities in Nanjing as an example and evaluated the service quality of the facilities from the perspectives of supply and demand. Finally, we found that the existing medical facilities in downtown areas basically satisfy the surrounding residents’ medical needs, although spatial heterogeneity also exists in some boroughs. Based on these research findings, we assessed the specific developmental requirements of medical and health facilities in the current overall urban planning of Nanjing and proposed some advanced suggestions for the promotion and allocation optimization of facility services.
4. Discussion
4.1. Optimize and Improve Medical Facilities in the Main Urban Area, with a Focus on Enhancing Medical Facilities in the Peripheral Suburbs
Based on the relationship analysis between the supply and demand of medical facilities, as well as the relevant planning requirements of healthcare in overall urban planning, we propose some targeted suggestions to improve the allocation of medical facilities in Nanjing. Specifically, existing medical facilities in downtown areas have satisfied the surrounding residents’ medical needs, and the current planning policy does not require that tertiary hospitals in downtown areas scale up. Therefore, improving planning policy requires improving the quality and service level of medical facilities and scaling up the medical facilities (gradually promoting them to tertiary hospitals) in the Xuanwu and Jiangning boroughs, which is consistent with the analysis results. Improving the planning policy requires building a tertiary hospital separately and improving the service quality of existing medical facilities in Pukou, Lishui, and Gaochun boroughs. The results also show that the quality of medical facilities allocated to the suburbs was relatively lower than that in downtown areas. Therefore, we suggest promoting medical service quality in Qixia borough by strengthening the allocation of tertiary and special hospitals because of the relatively low quality of local medical facility allocation and service satisfaction.
We draw conclusions based on the results of data analysis. First, there is heterogeneity in the supply and demand relationship of medical resources in various regions of Nanjing. Within the main urban area, Gulou District and Qinhuai District show a high level of supply and demand balance, Xuanwu District and Yuhuatai District show a moderate level of balance, Jianye District, Qixia District, and Jiangning District show a low level of balance, while Lishui District, Gaochun District, and Liuhe District show a significant mismatch in supply and demand. Second, from the perspective of factors that affect the satisfaction of medical facility services, the service attitude, service efficiency, and service quality of medical institutions are the core factors, followed by the convenience of residents in accessing medical resources, with an overall significant positive correlation (p < 0.01). The specific mechanism of action includes the following points. First, areas with a dense layout of public service facilities are usually located in the central urban area of the city. Although there is a high density and level of facility supply, and the accessibility of facilities is generally high, service quality and efficiency are still key factors affecting satisfaction. Second, the scale of facilities has a significant positive impact on resident satisfaction through the mediating effect. Research has shown that spacious, comfortable, and large per capita public service facilities have a significant impact on the user experience of residents, and improving facility supply is an important aspect of improving resident satisfaction. Some studies also suggest that the increase in facility scale will to some extent reduce the convenience and ease of use of facilities, and it is necessary to balance facility scale indicators and accessibility indicators. Finally, the quality of public service facilities comes from the intuitive perception of residents regarding public service facilities. Some studies suggest that the quality of public service facilities is reflected in multiple aspects such as safety, convenience, comfort, and aesthetics. Improving the service quality of public service facilities is the most direct and efficient way to manage and improve satisfaction.
4.2. Provide Precise Public Services Based on Supply and Demand Relationships to Maximize Facility Utilization Efficiency
Depending on the facility service location theory, it is necessary to rationally lay out public service facilities and maximize facility efficiency and social welfare because of the government’s limited financial capacity. Public service facility allocations should also provide public services to all citizens equally [
48]. Presently, medical service quality shows a dualistic differentiation, because the medical service level is relatively higher in downtown than in suburban areas. Resource allocation and service quality should be counterbalanced by strengthening the construction of high-grade medical facilities in suburban areas and transferring high-level urban medical resources to the suburbs. However, this equalization is not average, meaning that residents have the same rights to access public services, and their rights do not depend on the backward economic conditions of their living area. This implies maintaining a basic level of public service quality at no less than the average level in all regions and ensuring that residents have equal opportunities. The final public service equalization status should reflect residents’ access to efficient and convenient public service quality in different regions, between urban and rural areas, and between individual residents. On the other hand, equalization is not a fixed state or ultimate goal, but a process of dynamic adjustment, which means maintaining a dynamic balance between the quantity and quality of public service facilities in downtown and suburban areas. The equalization of public service facilities in different areas should be improved from a ‘balanced quantity stage’ to a ‘balanced quality stage’ with continuous social economic development. This development should maintain the equalisation of facilities and services, guarantee the density of the facilities, and enrich facility types in the allocation process to achieve equality of opportunity for all types of residents. Second, facility allocation should guarantee facility standardization, and the policy should focus on the full coverage and sharing of high-quality resources.
4.3. Strengthen Functional Complementarity and Network Connectivity between Medical Facilities of Different Levels
To advance the work of the government and planning departments, the traditional configuration method of public service facilities requires innovations based on the type and size of land use, population distribution, service radius, and other indicators. New methods and technologies, such as the internet, mobile phones, GPS, and other big data analysis methods, should be adopted to measure the daily living patterns and needs of residents in different regions. Service efficiency and satisfaction with public service facilities can be evaluated on this basis. Then, the facilities’ layout, scale decision, and regional collaborative planning can be implemented reasonably, as well as upgrades and reconstruction of facilities. However, attention should be paid to the layout balance and policy guidance of public service facilities at different spatial scales, such as downtown and suburban areas, old towns, newly developed areas, commercial areas, and other peripheral areas. For example, the government should increase investments in community-level medical facilities and establish a sound medical service system to promote the rational and efficient flow of medical resources. The promotion of subway network operations, intercity rail, and other rail transit, as well as the layout of public bicycles and shared bicycles, should be prioritized to strengthen traffic links between downtown cities and suburban areas. Optimizing the construction of parking lots around medical facilities, intelligent transformation, and establishing a comprehensive metropolitan area integrated transport service system would enhance the spatial accessibility of medical facilities.
4.4. Actively Guide Refinement and Improvement of Medical Facility Functions Based on the Supply–Demand Relationship of Medical Facilities
High-precision and long-term resident activity trajectories can be effectively measured and obtained through the widespread use of sensor networks, location-based services (LBS), and other kinds of ICT. An increasing number of studies have focused on the perspective of residents’ activities and demand, to identify existing city problems and seek the optimized direction of urban space updates. Meanwhile, we can grasp the overall characteristics of urban operations, such as urban land use level, traffic congestion, and material information contact, from a macroscopic perspective based on the activity data of resident groups. Therefore, the government could allocate resources and facilities, such as the layout of large targeted medical facilities. Finally, the research scale of public service facility allocation has also transformed into a refined community scale; however, an imbalance in the supply and demand for medical facilities still exists. Through the collection of residents’ individual activity data, the activity characteristics and actual needs of local residents can be effectively grasped from the street, community, and other micro levels to provide a new decision-making basis for the spatial layout and function optimization of community-based medical facilities that meet individual needs (
Figure 11).
5. Conclusions
5.1. Key Findings
Based on a review of existing literature, this study constructed a facility service quality evaluation system from the perspective of activities. Based on this, an overall evaluation of the current service quality of medical facilities in Nanjing was conducted from the perspective of residents’ needs and actual use. In combination with the relevant planning requirements in the fields of traditional Chinese medicine and health in the current urban master plan, targeted development suggestions for improving facility functions and optimizing layouts are proposed as follows:
(1) Medical facilities present a centrally aggregated, permanently scattered distribution pattern. Research has found a significant gap in the layout level of medical facilities between the central urban area and peripheral areas in Nanjing, and the spatial distribution has a strong agglomeration effect. New medical resources have not strengthened the construction of medical facilities in peripheral areas with the development of the city, and the trend of resource concentration towards urban areas is more obvious.
(2) The intensity of medical facility usage presents a clustering feature in the main city centre. The overall feature of the intensity of medical facility usage in Nanjing city is ‘high centre periphery’. Gulou and Qinhuai Districts had the highest total usage of medical facilities; Xuanwu, Jiangning, and Qixia Districts had a higher usage intensity of some medical facilities, while other areas had a relatively lower usage intensity. From the perspective of facility usage frequency, the per capita usage frequency of large medical facilities in each district was relatively high, whereas the usage frequency of small- and medium-sized medical facilities decreased gradually at the facility level.
(3) The rating levels of medical facilities exhibit multi-centre distribution characteristics. High-quality medical resources were concentrated within the main urban areas, presenting a pattern in which the south was better than the north. The layouts of medical service outlets in suburban and township areas are relatively scattered and service quality is uneven. In terms of online ratings, high-scoring facilities cluster in the Gulou and Qinhuai Districts, while the distribution of facility ratings in other districts is balanced. In terms of Weibo text evaluation, in addition to presenting the characteristics of high evaluation clustering of large hospitals in the central urban area, some hospitals in the Liuhe and Lishui Districts also had high Weibo evaluations. In terms of measuring patient emotions, patients in large hospitals generally had lower emotions, whereas patients in small- and medium-sized medical institutions generally had higher emotions.
5.2. Implications
This study is a positive attempt to evaluate facility service satisfaction based on residents’ activity data. It enriches the data sources and methods for the evaluation of public service facilities from the perspective of residents’ demand. In addition to urban renewal projects, this method can also be applied to pre-investigation and current status analysis in urban master planning, which has a wide range of application values. Existing research lacks an in-depth analysis of the synergy among medical service networks in different regions. In the future, the functional optimization of medical facilities should actively build integrated functional systems and conduct targeted functional promotion and complementarity. In addition, future research should focus on the following two aspects: medical facility allocation should consider the surrounding urban residential land layout and a reasonable prediction of the future population distribution to reduce idleness or over-utilization of medical resources. As the marginal zone between city and country areas, the suburbs also provide important supportive functions for urban–rural integration. The allocation of public service resources in rural and other urban fringe areas should be strengthened to narrow the gap between them and the city centre. The disparities among boroughs can effectively absorb the labour force in suburban areas and ease pressure on urban public service facilities which need more attention.
5.3. Limitations and Future Research Directions
This paper selects a specific period of a single city to obtain internet data as part of the data source. Compared with traditional statistical data, the magnitude, scale, and fineness of data have comparative advantages, but there are also some limitations and biases. First, the samples obtained from online data still have limitations and cannot obtain full sample data. Among all the people who use medical facilities, middle-aged and elderly people account for a large proportion. These people are not skilled in the use of mobile phones and the internet. It may be that people who often use the facilities have not published microblog comments, which reduces the accuracy of model analysis. Second, in the current environment, the speed of network information update is very fast. From the perspective of application, the timeliness of internet big data is often very short. Any data are located on a continuous timeline and has a temporal attribute, which is the age of the data. Data of different ages have different value characteristics, and traditional statistical data often have the value of overall or trend analysis. Internet data are more conducive to provide feedback on the space–time distribution characteristics of specific time nodes. In the subsequent research process, we further collected data from multiple time nodes, conducted comparative analysis before and after, and cross-validated the accuracy and rationality of the research conclusions.
Currently, research on the evaluation of public service facilities in China exists mainly in the fields of planning, geography, and government management. Facility allocation research has made great progress from a beginning of fully accepting foreign theories to consideration of China’s national requirements [
49]. For the planning department, urban renewal work focuses more on planning, implementation, and evaluation in the current development stage [
50]. To promote functional enhancement and optimization allocation, a more comprehensive evaluation of existing facilities in terms of facility usage and service quality is required. Public service facility planning policies should change from their previous focus by relying on a single land-use population size, block level, and other static indicators to consider the needs of residents and carry out human-oriented planning.
This study mainly calculated satisfaction with medical facilities based on residents’ activity data. Users of social network platforms such as Sina microblogs and facility review websites are mainly young people, which creates a biased sample. Nevertheless, we built an evaluation index system mainly from the perspective of residents’ demands based on residents’ check-in and review data. Integrating these new evaluation indexes into the existing evaluation index system and balancing the relationship between allocation supply and resident demand is a key direction for further research.