Review Reports - Innovative Spatial Equity Assessment in Healthcare Services: Integrating Travel Behaviors with Supply–Demand Coupling

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

The manuscript offers a technically ambitious and thematically relevant contribution to the literature on spatial equity in healthcare services. The integration of travel behavior with supply demand coupling represents a potentially valuable methodological advance. Nevertheless, the current version suffers from substantial weaknesses in structure, conceptual focus, and especially in the quality and communicative effectiveness of figures. Significant revisions are required to improve analytical clarity, narrative coherence, and visual rigor.

1. The Introduction is excessively descriptive and literature driven. I recommend restructuring it around a clearly articulated research problem, explicitly stating the conceptual gap that existing accessibility based approaches fail to address.

2. The research objectives are listed but not analytically motivated. I suggest consolidating them into one concise paragraph that links each objective directly to a specific methodological or theoretical deficiency.

3. The Literature Review overlaps substantially with the Introduction. I recommend reducing redundancy and reorganizing this section around clearly defined thematic sub blocks.

4. The conceptual discussion of spatial equity is extensive but unfocused. I suggest clarifying early whether the study operationalizes opportunity equity, outcome equity, or a hybrid construct, and maintaining this distinction consistently throughout the manuscript.

5. The transition from conceptual discussion to methodological formulation is abrupt. I recommend adding a short synthesis subsection explicitly bridging theory and model design.

6.The justification for adopting the entropy weight method is weak. I suggest briefly comparing it with alternative weighting strategies and clarifying why it is preferable in this context.

7. The description of the G2SFCA implementation is overly detailed in formulaic terms but insufficiently clear in analytical logic. I recommend simplifying equations in the main text and moving part of the technical detail to an appendix.

8. The assumptions regarding travel behavior are strong but weakly defended. I suggest providing empirical or bibliographic justification for these assumptions and clearly acknowledging their implications.

9. The choice of parameters such as travel time thresholds and speed values lacks sensitivity analysis. I recommend at least a brief discussion of parameter uncertainty.

10. The Results section is excessively descriptive. I suggest reducing repetition and strengthening interpretation, particularly by explicitly linking spatial patterns to the proposed TB CCD framework.

11. Figures are a major weakness of the manuscript. I recommend a complete redesign, as current figures suffer from low resolution, poor color contrast, cluttered backgrounds, and weak cartographic hierarchy.

12. Map figures lack visual consistency. I suggest standardizing color scales, legends, fonts, and spatial references across all figures.

13. Several maps are visually overloaded and difficult to interpret. I recommend reducing background detail and prioritizing the thematic variable.

14. Figure captions are largely descriptive and add little analytical value. I suggest rewriting them to highlight the key message conveyed by each figure.

15. The frequency plots in Figure 6 are poorly designed and visually unbalanced. I recommend simplifying their layout and improving axis readability.

16. Tables are informative but unevenly formatted. I suggest standardizing table structure and simplifying overly dense cells.

17. The Discussion section partially repeats the Results. I recommend sharpening its analytical role by focusing on interpretation, comparison with recent studies, and theoretical implications.

18. Policy implications are relevant but generic. I suggest linking recommendations more explicitly to specific empirical findings and spatial configurations.

19. Limitations are acknowledged but understated. I recommend expanding this section to explicitly address data constraints, modeling assumptions, and generalizability.

20. The Conclusion reiterates results but lacks synthesis. I suggest emphasizing the conceptual contribution of the TB CCD framework and clearly delineating avenues for future research.

I am available for any clarification.

Kind regards.

Author Response

Response to Reviewer 1

Dear Reviewer 1,

We sincerely thank all the reviewers for their valuable and constructive comments on our manuscript titled “Innovative Spatial Equity Assessment in Healthcare Services: Integrating Travel Behaviors with Supply-Demand Coupling.” We have carefully considered each suggestion and have made comprehensive revisions to the manuscript accordingly. Below is our point-by-point response detailing the major changes made.

Point-by-point response to Comments and Suggestions for Authors

Comments 1: The Introduction is excessively descriptive and literature driven. I recommend restructuring it around a clearly articulated research problem, explicitly stating the conceptual gap that existing accessibility based approaches fail to address.

Response 1: The Introduction has been restructured. It now opens by directly stating the research problem: "existing studies predominantly focus on the static distribution of medical facilities or accessibility analyses under single transportation modes, failing to systematically integrate the variability in travel behaviors and the supply-demand coupling relationship." This more clearly highlights the gap this study aims to fill.

Comments 2: The research objectives are listed but not analytically motivated. I suggest consolidating them into one concise paragraph that links each objective directly to a specific methodological or theoretical deficiency.

Response 2: The previously dispersed objectives have been consolidated into a focused paragraph at the end of the Introduction. They are now framed as two core research questions that directly address identified limitations: (1) How do multi-modal travel behaviors influence assessment results? (2) How can "inequity deserts/oases" under different travel modes be identified for targeted planning?

Comments 3: The Literature Review overlaps substantially with the Introduction. I recommend reducing redundancy and reorganizing this section around clearly defined thematic sub blocks.

Response 3:Redundant background information overlapping with the Introduction has been reduced. Section 2.1 now focuses solely on the "Definition of spatial equity" (opportunity vs. outcome, horizontal vs. vertical). Section 2.2 is dedicated to the "Measure of spatial equity and its limitations," providing a clearer structure.

Comments 4: The conceptual discussion of spatial equity is extensive but unfocused. I suggest clarifying early whether the study operationalizes opportunity equity, outcome equity, or a hybrid construct, and maintaining this distinction consistently throughout the manuscript.

Response 4: A clear operational definition is now provided at the end of Section 2.1: "healthcare service spatial equity is defined as follows: a state of healthcare resource allocation that takes equity of opportunity as its core connotation and vertical equity as its supply mode..." This definition guides the subsequent methodological formulation and analysis.

Comments 5: The transition from conceptual discussion to methodological formulation is abrupt. I recommend adding a short synthesis subsection explicitly bridging theory and model design.

Response 5: A new subsection, "2.3 Research framework," has been added. It synthesizes the theoretical concepts and explicitly bridges them to the methodological design, outlining the four-stage analytical process (demand estimation, supply estimation, TB-CCD quantification, desert/oasis identification), which is also visualized in the new Figure 2.

Comments 6: The justification for adopting the entropy weight method is weak. I suggest briefly comparing it with alternative weighting strategies and clarifying why it is preferable in this context.

Response 6: A justification has been added in Section 3.2.2: "The entropy weight method is an objective weighting technique that determines weights based on the inherent variation of each indicator data, avoiding subjective bias. It is suitable for comprehensively evaluating healthcare service capacity with multiple indicators in this study."

Comments 7: The description of the G2SFCA implementation is overly detailed in formulaic terms but insufficiently clear in analytical logic. I recommend simplifying equations in the main text and moving part of the technical detail to an appendix.

Response 7: The core formulas necessary for reproducibility have been retained, but textual descriptions of intermediate derivations have been streamlined. The logical flow—calculating demand, calculating supply (via G2SFCA), and finally calculating the coupling coordination degree (TB-CCD)—is now more prominent.

Comments 8: The assumptions regarding travel behavior are strong but weakly defended. I suggest providing empirical or bibliographic justification for these assumptions and clearly acknowledging their implications.

Response 8: The assumptions in Section 3.2.3 are now supported by citations (e.g., Tao et al., 2023) describing how patients choose facilities and travel modes based on condition severity. The implications and simplifying nature of these assumptions are explicitly acknowledged in the Limitations section (5.3).

Comments 9: The choice of parameters such as travel time thresholds and speed values lacks sensitivity analysis. I recommend at least a brief discussion of parameter uncertainty.

Response 9:A third point has been added to the Limitations (5.3), stating: "the study sets a unified 15-minute travel threshold for all travel modes but does not consider differences in acceptable travel time for different medical needs..." It suggests future work could introduce time-series data for dynamic sensitivity analysis.

Comments 10: The Results section is excessively descriptive. I suggest reducing repetition and strengthening interpretation, particularly by explicitly linking spatial patterns to the proposed TB CCD framework.

Response 10: The interpretation in the Results section has been strengthened to explicitly connect observed spatial patterns with the core logic of the TB-CCD model. For example, when discussing Figure 7, it is clarified that low coupling coordination degrees in the city center reflect a "mismatch between high demand and insufficient community-level supply."

Comments 11: Figures are a major weakness of the manuscript. I recommend a complete redesign, as current figures suffer from low resolution, poor color contrast, cluttered backgrounds, and weak cartographic hierarchy.

Response 11:: All figures (Figures 1-8) have been completely redesigned and recreated. Resolution has been increased, color schemes optimized (using ColorBrewer sequential/diverging palettes), background details simplified, and thematic elements given clear visual hierarchy. All are now in ".jpg" format for clarity.

Comments 12: Map figures lack visual consistency. I suggest standardizing color scales, legends, fonts, and spatial references across all figures.]

Response 12: All spatial distribution maps (Figs. 4, 5, 7, 8) have been standardized: using a consistent vectorized boundary of Xi'an central districts as the base map; employing identical color ramps and classification breaks for comparable maps (e.g., supply across modes); and unifying legend styles, fonts, and scale bars.

Comments 13: Several maps are visually overloaded and difficult to interpret. I recommend reducing background detail and prioritizing the thematic variable.]

Response 13: Background layers in all maps have been significantly simplified, retaining only essential major roads and administrative boundaries at reduced opacity. This ensures the polygonal areas representing thematic variables (supply level, equity score, desert/oasis) are the clear visual focus.

Comments 14: Figure captions are largely descriptive and add little analytical value. I suggest rewriting them to highlight the key message conveyed by each figure.]

Response 14: All figure captions have been rewritten to not only describe the content but also highlight the key finding. E.g., the caption for Figure 7 now reads: "Spatial distribution of healthcare service spatial equity under different travel modes (revealing a distinct core-periphery pattern and better equity for public transport and driving)."

Comments 15: The frequency plots in Figure 6 are poorly designed and visually unbalanced. I recommend simplifying their layout and improving axis readability.]

Response 15: Figure 6 has been redesigned. The frequency distribution subplots for the four travel modes are now arranged side-by-side with consistent axis ranges and scales. Clearer bar colors are used, and key data points (e.g., mean equity scores) are annotated for immediate comparison.

Comments 16: Tables are informative but unevenly formatted. I suggest standardizing table structure and simplifying overly dense cells.]

Response 16:All tables (Tables 1-3) have been reformatted for consistency in font, row height, and column width. Content in Table 3 (optimization strategies) has been condensed from lengthy sentences into concise bullet points where possible, enhancing readability.

Comments 17: The Discussion section partially repeats the Results. I recommend sharpening its analytical role by focusing on interpretation, comparison with recent studies, and theoretical implications.]

Response 17:The Discussion section has been restructured. Section 5.1 now focuses on Methodological Contributions (advantages of TB-CCD over single-mode models, addressing planning pain points). Section 5.2 develops Planning Implications based on quantitative findings, minimizing simple repetition of results.

Comments 18: Policy implications are relevant but generic. I suggest linking recommendations more explicitly to specific empirical findings and spatial configurations.

Response 18: In Section 5.2, each planning recommendation is now explicitly linked to specific empirical results. For example, the strategy for "walking mode deserts" is tied to the finding of "poorest equity for walking" and their specific locations shown in Figure 8a. Strategies are differentiated by travel mode and spatial type (core vs. suburb).

Comments 19: Limitations are acknowledged but understated. I recommend expanding this section to explicitly address data constraints, modeling assumptions, and generalizability.

Response 19: Section 5.3 "Limitations and Future Research" has been expanded. Three key limitations are now discussed in detail: (1) assumption of even population distribution within communities, (2) lack of demographic stratification, and (3) uniform travel time threshold. For each, future research directions using finer-grained data, demographic variables, or dynamic models are proposed.

Comments 20: The Conclusion reiterates results but lacks synthesis. I suggest emphasizing the conceptual contribution of the TB CCD framework and clearly delineating avenues for future research.

Response 20: The Conclusion (Section 6) has been completely rewritten. It begins by summarizing how the study addresses three key limitations, synthesizes the core findings, and then dedicates a paragraph to elaborating on the threefold conceptual contribution of the TB-CCD framework: bridging behavioral geography and equity theory, applying "coupling" to quantify supply-demand interdependence, and downscaling assessment to residential areas. Future research avenues are clearly stated.

Summary

Once again, we extend our deepest gratitude to all reviewers for their insightful and constructive feedback. Through these comprehensive revisions, the manuscript has been substantially improved in terms of problem focus, logical coherence, methodological rigor, analytical depth, visual presentation, and theoretical/practical contribution. We believe the revised manuscript adequately addresses all the concerns raised and hope it now meets the standard for publication.

We look forward to your further evaluation.

Sincerely

Reviewer 2 Report

Comments and Suggestions for Authors

The authors have successfully explored on the innovative spatial equity assessment in healthcare services.
The topic is relevant, and theoretical background is well presented.
There are considerable number of relevant references used in this study.
Abstract Section has precisely stated the aim and outcomes of the research. The aim must be the same and consistent stating throughout the study.
What is/are the main question/s addressed in this research? Is this mentioned in the abstract?
The author may avoid stating “Our integration of…….” in the entire document especially in the conclusion section. Instead, they may write “This research integrates……..”. ‘I’, ‘We’ and ‘Our’ should be avoided.
Page three states, “The primary objective of this study is to integrate travel behaviours with the Supply-Demand Coupling approach to develop a comprehensive framework for assessing spatial equity in healthcare services.” Is this (objective) different from the research aim mentioned in the Abstract Section? If it is different from the aim, why is it not mentioned in the Abstract Section? Where is the ‘comprehensive framework’? Is the Figure 2 presents the comprehensive framework? Or this is the research methodological framework?
Section two supposed to describe methodological process, explains different methods, and how the data is collected, etc. Instead, this section title is “Literature review”. Introduction Section already contains review of the literature. This section is descriptive and therefore requires a methodological framework to illustrate a unified picture of different stages, methods/techniques/tools and their connections to achieve the aim/objectives of this study.
Conclusions are not consistent with the evidence and arguments presented because of the main question/s were not clearly identified at beginning of this study and i.e. the concluding remarks did not address the main question/s posed. Therefore, conclusion section needs to be revised and rewritten.
First sentence of Conclusion Section states, “Our integration of spatial equity concepts, inspired by coupling models in physics, provides a novel framework for evaluating the spatial equity of healthcare services”. Where is the novel framework (Figure number?)?

Author Response

Response to Reviewer 2

Dear Reviewer 2,

Point-by-point response to Comments and Suggestions for Authors

Comments 1-4: The authors have successfully explored on the innovative spatial equity assessment in healthcare services.

The topic is relevant, and theoretical background is well presented.

There are considerable number of relevant references used in this study.

Abstract Section has precisely stated the aim and outcomes of the research. The aim must be the same and consistent stating throughout the study.

Response 1-4: Thank you for your encouraging remarks regarding the innovation, relevance, theoretical foundation, references, and clarity of the abstract. We have ensured that the research aim remains consistent throughout the manuscript, from the abstract through to the conclusion.

Comments 5: What is/are the main question/s addressed in this research? Is this mentioned in the abstract?

Response 5: Consistency has been ensured. The research aim stated in the Abstract (to establish a TB-CCD method) aligns with the core objective throughout the manuscript. The two main research questions are now explicitly presented at the end of the Introduction and are addressed in the Abstract's summary of outcomes.

Comments 6: The author may avoid stating “Our integration of…….” in the entire document especially in the conclusion section. Instead, they may write “This research integrates……..”. ‘I’, ‘We’ and ‘Our’ should be avoided.

Response 6: The manuscript has been thoroughly revised to use objective, third-person language. For instance, "Our integration" was changed to "This study integrates…" or "The research integrates…"; "We propose" became "This study proposes…".

Comments 7: Page three states, “The primary objective of this study is to integrate travel behaviours with the Supply-Demand Coupling approach to develop a comprehensive framework for assessing spatial equity in healthcare services.” Is this (objective) different from the research aim mentioned in the Abstract Section? If it is different from the aim, why is it not mentioned in the Abstract Section? Where is the ‘comprehensive framework’? Is the Figure 2 presents the comprehensive framework? Or this is the research methodological framework?

Response 7: The description of the study's purpose has been unified. The "comprehensive framework" refers to the integrated assessment framework incorporating multi-modal travel behavior and supply-demand coupling (TB-CCD). Figure 2 is now explicitly labeled the "Research framework," visually representing the complete logical flow from concepts to methods to output.

Comments 8: Section two supposed to describe methodological process, explains different methods, and how the data is collected, etc. Instead, this section title is “Literature review”. Introduction Section already contains review of the literature. This section is descriptive and therefore requires a methodological framework to illustrate a unified picture of different stages, methods/techniques/tools and their connections to achieve the aim/objectives of this study.

Response 8: Section 2 has been refined to be a purer literature review (Definitions and Measures). The new Section 2.3 "Research framework" and its corresponding Figure 2 now clearly illustrate the methodological process across four stages, providing a unified picture of how the study's aim is achieved.

Comments 9: Conclusions are not consistent with the evidence and arguments presented because of the main question/s were not clearly identified at beginning of this study and i.e. the concluding remarks did not address the main question/s posed. Therefore, conclusion section needs to be revised and rewritten.

Response 9: The core research questions are now clearly posed at the outset (end of Introduction). The revised Conclusion directly addresses these questions, synthesizes the evidence to answer them, and discusses the broader implications, ensuring logical consistency.

Comments 10: First sentence of Conclusion Section states, “Our integration of spatial equity concepts, inspired by coupling models in physics, provides a novel framework for evaluating the spatial equity of healthcare services”. Where is the novel framework (Figure number?)?

Response 10: The "novel framework" is the Travel Behavior-based Coupling Coordination Degree (TB-CCD) framework developed in this study. Its full composition and workflow are presented in Figure 2 (Research framework) and detailed in Sections 2.3 and 3.2.

Summary

We look forward to your further evaluation.

Sincerely

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you very much for the interesting article, which is timely and raises important issues. However, before its publication, I recommend making some corrections:

1) The research problem was not clearly and unambiguously formulated – the authors present the objectives in the form of a list of tasks, which weakens it.
2) The introduction serves as an extended literature review, instead of clearly presenting the essence of the problem, the motivation for the study, and its significance. I recommend clearly separating the introduction from the literature analysis.
3) The research methods are sound and adequately justified. The analytical procedures and mathematical formulas used allow for replication of the study in other cities (if appropriate data are available, which should be noted in the limitations).
4) The graphic elements are one of the article's strongest points. The maps are very readable and attractive. The data are interpreted coherently. Here I would like to congratulate the authors.
5) The conclusions are consistent with the presented results, although some of them are descriptive in nature. I strongly recommend that the authors include a separate "Discussion" section to place the results in a broader scientific context. This is what I find most lacking in this article.

Author Response

Response to Reviewer 3

Dear Reviewer 3,

Point-by-point response to Comments and Suggestions for Authors

Comments 1: The research problem was not clearly and unambiguously formulated – the authors present the objectives in the form of a list of tasks, which weakens it.

Response 1: The research objectives have been refined and presented as two clear, focused research questions at the end of the Introduction, enhancing the problem statement.

Comments 2: The introduction serves as an extended literature review, instead of clearly presenting the essence of the problem, the motivation for the study, and its significance. I recommend clearly separating the introduction from the literature analysis.

Response 2: The Introduction has been refocused to establish the research problem, significance, and gaps. The more detailed conceptual analysis and literature review on measurement methods have been moved to Section 2, creating a clearer separation.

Comments 3: The research methods are sound and adequately justified. The analytical procedures and mathematical formulas used allow for replication of the study in other cities (if appropriate data are available, which should be noted in the limitations).

Response 3: Thank you for this positive assessment. We have ensured the Methods section is clear and replicable, while also noting data requirements in the Limitations.

Comments 4: The graphic elements are one of the article's strongest points. The maps are very readable and attractive. The data are interpreted coherently. Here I would like to congratulate the authors.

Response 4 We sincerely appreciate this encouraging feedback. We have further refined the figures based on other reviewers' suggestions to enhance consistency and clarity.

Comments 5: The conclusions are consistent with the presented results, although some of them are descriptive in nature. I strongly recommend that the authors include a separate "Discussion" section to place the results in a broader scientific context. This is what I find most lacking in this article.

Response 5: This crucial suggestion has been adopted. The revised manuscript now includes a dedicated Section 5: "Discussions", with subsections on methodological contributions, planning implications, and limitations/future research, providing the necessary broader scientific context.

Summary

We look forward to your further evaluation.

Sincerely

Reviewer 4 Report

Comments and Suggestions for Authors

This study focuses on the core issue of social equity—spatial equity in medical services—and conducts empirical analysis to address the shortcomings of existing methods, which overlook the coupling of supply and demand as well as the impact of travel behavior. Methodologically, it constructs a TB-CCD model, integrating the G2SFCA and coupling coordination degree methods. The data encompasses medical facilities, population, and road networks in the central urban area of Xi'an, with key information obtained through Baidu location big data and open platform APIs. The innovation lies in the first-time deep integration of travel behavior and supply-demand coupling, enabling refined assessment of spatial equity in medical services under multiple modes. The applied value is reflected in its ability to provide a scientific basis for the planning of medical facilities and the design of spatial resource optimization policies in Xi'an's urban areas.

Suggestions for improvement

Introduction section: The core differences between the TB-CCD model and existing coupling coordination models are not clearly specified. It is recommended to supplement specific descriptions of the model's innovations, such as breakthroughs in indicator integration and travel behavior quantification, to enhance the recognition of methodological novelty.

Literature Review: The review relies heavily on outdated literature, such as works from 1993 or 1994. While the fairness of medical services is a traditional and classic topic, for an academic paper rather than a dissertation, authors are expected to focus more on recent publications unless citing seminal works.

Data and Methods: The weight settings of α=0.4 and β=0.6 lack detailed justification. It is recommended to supplement the analytical process for weight determination or conduct a sensitivity analysis to verify the impact of weights on the results, thereby enhancing the credibility and rigor of the paper.

Discussion: The core value of the paper lies in proposing novel methods with significant practical applications. However, the planning strategies introduced in the paper currently exhibit weak correlation with the analytical results, and their operational feasibility requires further enhancement. The most important thing is to link the optimization strategy with Xi'an's national spatial planning and medical facility layout planning, pointing out the shortcomings of the current planning and possible improvement directions in the future.

Figures: Some figures have unclear legend annotations (e.g., Figures 4-8). It is recommended to optimize the legend design, supplement key information annotations, and enhance figure readability.

References: The latest references are relatively scarce and do not conform to the formatting requirements of the LAND journal. It is recommended to integrate optimizations in sections such as literature review, results analysis, and discussion, and appropriately supplement the most recent research findings published since 2023 to reflect the cutting-edge nature of the study. Additionally, the reference list should be formatted according to the LAND template.

Author Response

Response to Reviewer 4

Dear Reviewer 4,

Point-by-point response to Comments and Suggestions for Authors

Comments 1: The core differences between the TB-CCD model and existing coupling coordination models are not clearly specified. Describe innovations in indicator integration and travel behavior quantification.

Response 1: The innovation of the TB-CCD model is now emphasized in the Introduction and Section 5.1. We highlight its two key breakthroughs: (1) Multi-modal integration—simultaneous assessment across four travel modes, and (2) Behavioral logic embedding—incorporating assumptions linking health condition, facility level, and travel mode choice, shifting the paradigm from static resource assessment to dynamic behavior-resource matching.

Comments 2： The Literature Review relies heavily on outdated literature. Focus more on recent publications.

Response 2: The reference list has been substantially updated, with over 30 new references from 2020-2024 added, particularly in areas of advanced accessibility methods, multi-modal transport, and health geography. Citations of seminal works (e.g., 1993, 1994) are retained only for foundational concepts.

Comments 3:The weight settings α=0.4 and β=0.6 lack detailed justification. Supplement the analytical process or conduct sensitivity analysis.

Response 3: A rationale has been added near Equation (9): "Considering that spatial equity in healthcare services places greater emphasis on responding to demand, and with reference to related studies comparing the importance of supply and demand, this study assigns a slightly higher weight to demand (β=0.6) than to supply (α=0.4)." The need for sensitivity analysis in future work is acknowledged in Section 5.3.

Comments 4: Planning strategies exhibit weak correlation with analytical results. Link them to Xi'an's spatial planning and medical facility layout.

Response 4: Section 5.2 has been significantly strengthened:

Stronger Correlation: Each strategy is now directly tied to specific quantitative results (e.g., "Figure 8c shows public transport deserts are located beyond the Third Ring Road").

Planning Integration: Strategies are explicitly connected to contemporary planning concepts like the "15-minute community life circle," "synergistic planning of medical facilities and public transport hubs in new urban areas," and "micro-regeneration to supplement community healthcare in the central city," suggesting directions for optimizing current plans.

Comments 5: Some figures have unclear legend annotations (Figs. 4-8). Optimize legend design and enhance readability.

Response 5: Legends for all maps have been redesigned. Legend titles are explicit, classification labels are clear, and color ramps are distinct. Key geographical markers (e.g., "Ming City Wall," "Second Ring Road") have been added as text annotations to the figures where necessary for orientation.

Comments 6: The latest references are relatively scarce and the format does not conform to the LAND journal requirements.

Response 6: Updated References: A significant number of the most recent (2023-2024) publications have been integrated into the literature review, results analysis, and discussion.

Format Compliance: The entire reference list has been meticulously checked and formatted according to the author-year citation style required by the LAND journal template.

Summary

We look forward to your further evaluation.

Sincerely

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

The revised manuscript shows clear progress in addressing many of the concerns raised during the first review round, particularly with respect to problem framing, structural organization, and the articulation of the TB-CCD framework. Nevertheless, important recommendations from the first round have only been partially addressed and still require revision before the manuscript can be considered fully satisfactory.

1. The justification for adopting the entropy weight method remains incomplete. Although its objective nature is now stated, the manuscript still lacks the requested brief comparison with alternative weighting strategies (e.g., equal weights, AHP, PCA-based approaches) and a clear explanation of why entropy weighting is preferable in this specific analytical context.

2. The methodological section continues to be overly dense in mathematical detail. Despite some streamlining, derivations and intermediate formulaic steps remain in the main text. As previously recommended, these elements should be moved to an appendix or supplementary material, retaining only the equations strictly necessary to convey analytical logic and reproducibility.

3. The Results section still contains passages that are predominantly descriptive, with repeated enumeration of spatial patterns already evident in the figures. Further effort is needed to strengthen interpretation, explicitly linking each major result to the logic and added value of the TB-CCD framework rather than reiterating mapped distributions.

4. Language and typographical quality require substantial improvement. The current version still contains visible linguistic artifacts and encoding issues that undermine clarity and professionalism. A thorough and careful English language revision is required prior to acceptance.

I am available for any clarification.

Kind regards.

Author Response

Response to Reviewers

Dear Reviewer,

Thank you for your valuable comments and suggestions on our manuscript titled “Innovative Spatial Equity Assessment in Healthcare Services: Integrating Travel Behaviors with Supply-Demand Coupling.” We have carefully revised the manuscript according to your feedback. Below is our point-by-point response detailing the changes made.

Comments 1: The justification for adopting the entropy weight method remains incomplete. Although its objective nature is now stated, the manuscript still lacks the requested brief comparison with alternative weighting strategies (e.g., equal weights, AHP, PCA-based approaches) and a clear explanation of why entropy weighting is preferable in this specific analytical context.

Response 1:

We have added a comparative discussion of weighting methods in Appendix A.2. This addition briefly outlines equal weighting, the Analytic Hierarchy Process (AHP), and Principal Component Analysis (PCA), and explains why the entropy weight method was selected for its objectivity and suitability in deriving a data-driven, unbiased composite measure of healthcare facility capacity for equity modeling.

Comments 2: The methodological section continues to be overly dense in mathematical detail. Despite some streamlining, derivations and intermediate formulaic steps remain in the main text. As previously recommended, these elements should be moved to an appendix or supplementary material, retaining only the equations strictly necessary to convey analytical logic and reproducibility.

Response2:

We have restructured the Methods section (Section 3.2) to improve readability. Detailed computational steps—including the full entropy weighting procedure (formerly Eqs. 1–4) and the explicit form of the Gaussian decay function (formerly Eq. 6)—have been moved to Appendix A.2 and A.3. The main text now retains only the core formulas essential for understanding the G2SFCA and TB-CCD models (Eqs. 5, 7, 8, 9), with cross-references to the appendix for technical details.

Comments 3: The Results section still contains passages that are predominantly descriptive, with repeated enumeration of spatial patterns already evident in the figures. Further effort is needed to strengthen interpretation, explicitly linking each major result to the logic and added value of the TB-CCD framework rather than reiterating mapped distributions.

Response 3:

We have enriched the Results section (Section 4) with interpretive commentary, marked with square brackets “___”. These additions explicitly connect key findings—such as fine-scale demand heterogeneity, multi-modal supply patterns, the “depressed core” equity phenomenon, and the travel-mode-dependent distribution of deserts/oases—to the conceptual and analytical advantages of the TB-CCD framework, moving beyond mere description to highlight the model’s diagnostic and planning relevance.

Comments 4: Language and typographical quality require substantial improvement. The current version still contains visible linguistic artifacts and encoding issues that undermine clarity and professionalism. A thorough and careful English language revision is required prior to acceptance.

Response 4:

We have performed a round of language and formatting corrections, addressing several grammatical errors, misspellings (e.g., “DemSand” has been corrected to “Demand”), and encoding inconsistencies to improve the clarity and professionalism of the text.

We believe these revisions have significantly strengthened the manuscript and addressed the core concerns raised. Thank you again for your constructive review.

Sincerely,

The Authors

Reviewer 2 Report

Comments and Suggestions for Authors

thank you for addressing the comments

Author Response

Dear Reviewer,

Sincere thanks to all the reviewing experts for their valuable opinions and meticulous review of the research paper 'Innovative Spatial Equity Assessment in Healthcare Services: Integrating Travel Behaviors with Supply-DemSand Coupling'. We are very grateful to the reviewing experts for their recognition of the innovation, relevance, and theoretical foundation of this article, and highly value all constructive opinions.

Sincerely,

The Authors