Assessing the Age-Friendly Built Environment Surrounding Healthcare Facilities Using GIS and Multisource Data: Evidence from Fuzhou, China

An age-friendly built environment surrounding healthcare facilities can support older adults’ healthcare use and everyday activities. Existing studies have paid limited attention to the built environment surrounding healthcare facilities as an integrated setting. This study developed a healthcare-facility-centered framework to assess the age-friendly built environment in Fuzhou, China. Using GIS-based spatial analysis and multisource data, 3781 healthcare facilities were assessed across six dimensions: greenness exposure, health services, daily living services, social and leisure opportunities, healthcare accessibility, and functional mix. Questionnaire responses from 94 older-adult cases, including self-reports and caregiver-proxy reports, were used to derive dimension weights using the Entropy Weight Method (EWM). Three main findings emerged: (1) Higher-level healthcare facilities and more favorable integrated scores were concentrated in central urban areas, although spatial patterns varied across dimensions, particularly for greenness exposure, healthcare accessibility, and functional mix; (2) Level 3 healthcare facilities (L3HFs) had the highest median integrated score (0.613), compared with 0.345 for ungraded healthcare facilities (UHFs); and (3) 55.3% of respondents reported combining healthcare visits with shopping or leisure activities, while daily living services received the highest weight (26.4%). The uneven distribution of questionnaire responses across administrative areas may limit the representativeness of the perception-based assessment. The proposed framework can inform targeted improvements around healthcare facilities and support age-friendly planning in other cities.