基于可达性的医疗服务功能空间分异特征及其服务强度研究——以河北省张家口市为例

Research on the Spatial Differentiation of Healthcare Service Function and Its Intensity Based on Accessibility: A Case Study of Zhangjiakou City in Hebei Province

基于张家口市诊所、专科医院、综合医院三种类型的医疗服务点、交通网络、城镇村建设用地数据，采用GIS可达性空间分析与统计方法，对张家口市医疗服务功能空间分布特征进行制图，系统分析了张家口市医疗服务功能空间分异特征及其服务强度。结果表明：张家口市医疗机构点均呈现集聚分布态势，集聚程度由强到弱依次为专科医院〉综合医院〉诊所。专科医院与综合医院服在不同等级功能区的服务功能分布特征及服务强度分布趋势基本一致，而诊所医疗机构的服务功能及其服务强度远大于前两者，但仍存在9．46％和0．53％的建设用地面积诊所医疗服务可达性时间分别超过30min和60min。医疗服务总功能及其服务强度以中部市区为中心，以及各区、县城中心为次中心向外围逐渐减小，边远山区医疗服务较低。张家口市医疗服务资源配置区域分配不均衡，尤其在赤城县、沽源县、康保县、尚义县和张北县等乡村地区服务功能较弱。

The health care institution is the basic public resource of the social and economic development. The rationality of its spatial distribution directly affects the service function, and had a huge impact on health of the public. For this study, the methods of accessibility of GIS spatial analysis and statistical methods is used to mapping the spatial distribution characteristics of health care service function, and systematic analyzing its spatial differentiation characteristics and service intensity, based on the three types points of clinics, special hospital, and general hospital, Traffic network, the spatial distribution of construction land in Zhangjiakou city. Then, the total function of the health care service is analyzed by integrating the three types of medical function. The result showed that the health care institutions in Zhangjiakou present agglomeration distribution situation, and the agglomeration degree from strong to weak in turn is special hospital, general hospital, and clinics. In three types of medical service, the service function and its intensity in the area of different levels of the special hospital almost sames as general hospital, and clinic＇ s service function and its intensity is greater than the former two. Even so, there are still 9.46% and 0.53% of the construction land area of clinic accessibility time more than 30 min and 60 min, respectively. Total medical service function decreases by the district/county town center to the periphery gradually, and the remote mountainous areas medical services is low.Zhangjiakou medical service resources disposition unbalanced regional distribution, especially in the rural areas of the county of Chicheng, Guyuan, Kangbao, Shangyi, Zhangbei and so on, the healthcare service weak than other regions.