Objective To analyze healthcare accessibility and patient-load pressure of fever clinics (sentinel clinics) in Shanghai and optimize the spatial layout.

Methods Data on the daily maximum number of patient visits were collected from medical institutions operating fever clinics (sentinel clinics) in Shanghai. Thiessen polygon and buffer zone analysis methods were adopted to assess supply–demand ratios and healthcare accessibility of fever clinics (sentinel clinics) in Shanghai.

Results In 2024, patient visits to fever clinics (sentinel clinics) in Shanghai exhibited a seasonal pattern with higher volumes during winter and spring and lower volumes in summer and autumn. The 349 fever clinics (sentinel clinics) presented a spatial distribution pattern of being dense in the urban area and sparse in the suburban area. Seven townships experienced extreme pressure, and Xinchang town in Pudong new area had the lowest supply-demand ratio (< 1:100 000), with no suitable locations available nearby for building new fever clinics. Fourteen peripheral townships exhibited moderate pressure (supply-demand ratio < 1:10 000) and possessed suitable conditions for new fever clinics (sentinel clinics).

Conclusions The overall spatial distribution of fever clinics (sentinel clinics) in Shanghai is generally appropriate and adequately serves the needs of patients with fever. Nevertheless, an imbalanced distribution between urban and suburban areas remains, alongside the co-occurrence of resource strain and idleness. Measures such as redirecting patients to underutilized nearby fever clinics (sentinel clinics), establishing new fever clinics (sentinel clinics) in townships where conditions permit, adding more consultation rooms in areas where new construction is not feasible can alleviate the patient visit pressure for individuals with fever.