基于可达性的城市建成区医疗均等化分析——以大连市为例

Equalization analysis based on accessibility of urban built-up area medical——A case of Dalian

中国正处于城市化高速发展的阶段,医疗服务的均等化作为城市发展所面临的主要问题,其规划与布局对城市居民的身体健康具有决定性影响.利用GIS空间分析手段,系统地对大连市建成区医疗服务均等化水平进行分析与评价,并对缺医地区的医疗资源配给提出针对性建议.研究结果表明:(1)大连市建成区可达时间分布形式总体呈现由中心城区逐渐向外围地区递减的趋势,可达性值变化趋势是以中心城区可达性高值区沿主要交通线逐渐衰减;大连市建成区内各社区可达性平均值为2.16,其中,可达性最好的社区为学子社区,最差的社区为华鑫社区.人口密度、道路密度与医疗设施数量是造成可达性空间差异的主要原因.(2)根据LISA空间聚类模型所得结果,高水平地区主要集中在中心城区,不均衡地区与周边地区医疗资源分布差异显著,而低水平地区中营城子街道得分最高,应最先改善医疗资源在该地区内的分配.(3)通过GIS空间分析手段所得结果表明,大连市现有医疗资源分配基本均衡,应适当整合由中山公园、北京街、人民广场、白云和白山路街道所围成的地区内过于集中的医疗资源,避免医疗资源浪费.综合分析各街道人口、道路与土地使用情况后,认为凌水、营城子街道应各增加1处医院,红旗街道内应增加3处医院.

At present,China is in the stage of rapid urbanization.Equalization of medical services is a major problem faced by urban development.Its planning and layout have a decisive influence on the health of urban residents.Based on the data of streets,communities,population,traffic network and medical service points in the built-up area of Dalian City,this paper builds a database to analyze and evaluate the equalization level of medical services in built-up areas of Dalian using GIS spatial analysis method.And the lack of medical resources rationing areas put forward targeted recommendations.The results show that：（1）The accessibility time distribution patterns of the built-up areas in Dalian show a trend of decreasing gradually from the central urban area to the peripheral areas.The change trend of the accessibility values is based on the high accessibility of central urban areas,along the main traffic lines gradually decaying;the average accessibility of all communities in the built-up area of Dalian is 2.16,of which the best accessible subdistrict is 3.61 of the xuezi subdistrict and the worst subdistrict is 1.02 of Huaxin subdistrict.Population density,road density and the number of medical facilities are the main reasons for the spatial differences in accessibility.（2）According to the results of LISA spatial clustering model,the high-level areas are mainly concentrated in the central urban area,the distribution of medical resources in the unbalanced areas and the surrounding areas is significantly different,while in the low-level areas,Yingchengzi subdistrict has the highest score and should be the first to improve the medical resources distribution.（3）The results obtained by means of GIS spatial analysis show that the existing distribution of medical resources in Dalian is basically balanced and the medical resources in the areas surrounded by Zhongshan Park,Beijing street,People＇s Square,Baiyun and Baishan Road should be properly integrated,to avoid the waste of medical resources.After comprehensive analysis of the population,roads and land use of each street,this article considers that one additional hospital should be added to Lingshui and Yingchengzi subdistrict,and three hospitals should be added to Hongqi subdistrict.