Travel-time accessibility and adaptive spatial planning solutions for the healthcare system.

Ensuring equitable healthcare access remains a significant challenge, particularly in rural areas where aging populations face increasing barriers due to facility closures. This study employs a GIS-based spatial network model to assess hospital accessibility, integrate road characteristics, and estimate travel times across all officially registered population nodes in a region. Analyzing disparities by age composition, we identify high-risk exclusion areas and propose an optimized model prioritizing vulnerable populations. Through four optimization scenarios, we evaluate the impact of hospital reductions on territorial accessibility. Findings reveal significant gaps, disproportionately affecting elderly and remote communities. Strategic hospital redistribution can enhance system efficiency and equity. This research highlights the value of GIS-based approaches in healthcare planning, providing data-driven strategies for optimizing hospital distribution and informing evidence-based policymaking.