我国农村救护车资源布局优化:以河南省郸城县为例

OPTIMIZAITON OF AMBULANCE RESOURCES IN RURAL CHINA: A CASE STUDY OF DANCHENG COUNTY,HENAN PROVINCE

优化农村救护车资源的配置有助于缩短急救服务的响应时间,对于维护重症伤(病)员的生命安全具有重要意义。本研究以河南省郸城县为例,将15分钟作为急救车路上所需响应时间,研究了该县当前救护车资源布局下农村居民的可达性;应用ArcGIS中的p-中位模型优化了郸城救护车布局点,并运用SPSS16中的配对样本t检验对比了优化前后郸城居民救护车服务可达性变化;应用ArcGIS中的最小覆盖面模型求解了覆盖郸城县域所需的最少救护车布局点数。研究显示,通过优化能有效提高居民的救护车资源可达性,在县域范围内布局13个左右的救护车资源能基本覆盖所有居民点。这一数量对与郸城具有相似自然社会背景的黄淮海平原县域具有借鉴意义。最后,文章还讨论了研究存在的局限。

Increasing acute patients and the condition of revenue shortage in rural China require allocating ambulance resources both effectively and efficiently. In this study, we examined the location and allocation problem in Dancheng County, Henan Province, based on the data supplied by the county government. Using the shortest route analysis in the Network Extension in ArcGIS 10, we measured the current accessibility to the ambulance sites in the county. The results show that the average travel time from each settlement to the nearest ambulance site were 11.14 minutes. Of 489 settlements （971364 residents）, 370 settlements （749826 residents） were served within 15 minutes. We used the p-medium model provided by ArcGIS 10 to optimize the locations of 6 township hospitals among 20 ones. After optimization, 429 settlements （858423 residents） were served within 15 minutes. Using the paired t-test of the response times, we found that the response time significantly decreased after relocating the ambulance sites. Next, using 15 minutes as the response time, we, using the location set covering model （LSCM） in ArcGIS 10, explored the minimum number of ambulance sites that can cover all settlements within the county. The results indicate that 13 sites are appropriate for serving all settlements except for three ones. This number can be applied to the rural areas which have the physical and social-economic characteristics similar to the study area. We suggest that local governments in China should use the geographic information systems （GIS） technique to allocate public resources such as ambulance, because this technique has advances in reducing operating costs and in improving social justice. Additionally, the local government should also provide village doctors with emergence training skills, which can save the patient＇s life if he or she needs a shorter response time than 15 minutes to hospital.