Objective  With the continuous development of economy and society, the concept of inclusive design is gradually transitioning towards universal design, emphasizing the importance of supporting the construction of barrier-free environments for all individuals. Community health service centers, as fundamental units within urban medical grids and integral components of the hierarchical medical system, play a critical role in delivering healthcare services. Therefore, it is of paramount importance to focus on how to construct reliable and inclusive barrier-free environments within community health service centers, which remains a key research area in the field of barrier-free environment. In view of this, this research aims to construct an evaluation system for barrier-free environments in community health service centers, with a view to providing quantifiable design guidance for their future development and renovation. The ultimate goal is to create inclusive and barrier-free healthcare environments that offer comprehensive support in terms of physiological, social and psychological aspects for individuals with physical vulnerabilities across all age groups throughout the entire process of seeking medical care. By establishing an evaluation system that considers various dimensions, this research endeavors to contribute to the construction and improvement of barrier-free environments in community health service centers, and thus helps ensure equal access to healthcare services for all individuals, regardless of their physical capabilities.

Methods  To achieve this, this research initially reviews the major advancements in research on barrier-free environments in hospitals. Additionally, the research conducts a meticulous analysis on various physical environmental spaces that individuals may encounter throughout the entire process of seeking medical care in community health service centers. By thoroughly considering and selecting appropriate subjects, five community health service centers, including the one located in Yuangang Subdistrict, Tianhe District, Guangzhou City, are chosen as the research object. Following the principle of supportive design, the research develops a comprehensive evaluation system for assessing barrier-free environments in community health service centers by combining the methods of analytic hierarchy process (AHP) and fuzzy comprehensive evaluation. Moreover, the research introduces a novel approach by integrating research on supportive environmental design in healthcare settings. The evaluation system can assess the multidimensional support provided by barrier-free environments in community health service centers to individuals with physical vulnerabilities, taking into account physiological, psychological and social aspects.

Results  The research finally establishes an evaluation system for barrier-free environments in community health service centers, facilitating the comprehensive evaluation of the aforesaid barrier-free environments. The evaluation dimensions include sense of control, environmental compatibility, and social support. The research adopts the Delphi method to consult relevant domain experts and select indicators, and then assigns importance scores to the 14 identified barrier-free environment factors that potentially support the entire process of barrier-free medical treatment for individuals with physical vulnerabilities. This rigorous process enables the determination of weights for each factor. The empirical research findings demonstrate that among the five community health service centers evaluated, one center is rated “good”, two ones rated “average”, and the other two ones rated “poor”, indicating that the overall construction of barrier-free environments in community health service centers is less optimistic than anticipated. Additionally, there exist significant differences in the level of support provided by the identified barrier-free environment factors for individuals with physical vulnerabilities among different evaluation subjects. Furthermore, certain barrier-free environment factors are found to be lacking in specific evaluation subjects. When examining the multidimensional support encompassing physiological, psychological and social aspects, the research finds that the evaluated subjects generally exhibit weaker support in terms of psychological control and social support, while environmental compatibility shows relatively better results. Therefore, future endeavors should prioritize the design of barrier-free environments that address psychological and social dimensions.

Conclusion  In this research, the construction of evaluation system provides quantifiable design guidance and referential design process suggestions for the construction and updating of barrier-free environment in community health service centers. Meanwhile, as the fundamental components of primary healthcare, community health service centers deserve greater attention in terms of barrier-free environment. Currently, there is a dearth of research on the medical environments of primary healthcare institutions in China, including community health service centers, healthcare stations, township health centers, and village clinics, resulting in poor construction of barrier-free environments therein. In the future, the research focus should shift from secondary and tertiary hospitals towards primary healthcare institutions, including community health service centers.