Spatial Disparities in Access to Public and Private Long-Term Care Facilities in Hong Kong

Abstract

Long-term care facilities (LTCFs) provide institutional care for older adults, which improves their overall quality of life. Hong Kong, with a 20.5 percent aging rate in 2021, is now one of the world’s most rapidly aging cities. Few studies have systematically examined disparities in spatial accessibility between public and private LTCFs, particularly in high-density aging societies. This study addresses this research gap by evaluating spatial accessibility to LTCFs at the large subunit group level in Hong Kong and comparing service capacity across facility types. We applied spatial analysis and local regression methods to examine how accessibility correlates with socioeconomic characteristics. Our findings reveal that both public and private LTCFs cluster in traditionally developed urban areas, with private institutions dominating service provision. Regions with a higher concentration of low-income groups had lower access to LTCF resources, whereas regions with a higher concentration of single households had greater accessibility to LTCFs. Based on these findings, we recommend continued public LTCF subsidies and incentives for private-sector expansion into suburban areas. In conclusion, this research contributes to urban, human, and health geography by revealing the degree to which spatial inequality in LCTF access reflects broader patterns of social vulnerability and urban service provision.