基于改进两步移动搜索法的北碚区医疗设施空间可达性分析

Spatial Accessibility of Medical Facilities in Beibei District based on Modified Two-step Floating Catchment Area Method

针对当前医疗资源分布不均问题,本文以重庆市北碚区为例,以行政村为最小研究单元,借助GIS空间分析技术,将多级半径和高斯距离衰减函数相结合来改进两步移动搜索法,对北碚区医疗设施空间可达性进行研究。结果表明:①改进两步移动搜索法综合考虑了医院等级规模对居民的吸引力、距离衰减因素对居民出行意愿的影响等因素,在识别高可达性区域内部差异和边缘低可达性区域方面具有较高的敏感性,因此其计算结果能够更准确地刻画北碚区的医疗设施空间可达性特征;②北碚区整体医疗设施空间可达性较好,呈现由中心向四周递减的特征;③借助冷热点分析发现北碚区医疗设施可达性空间差异大,两极分异显著,高值区主要集中在东阳街道、朝阳街道、天生街道、北温泉街道和龙凤桥街道等中心城区,低值区主要集中在金刀峡镇、柳荫镇、三圣镇、复兴街道和静观镇等边缘地区。研究结果可为相关部门制定决策规划提供依据。

In recent years, China’s health industry has made rapid progress, but there are still gaps between different regions. As one of the basic public services, medical services is closely related to the quality of resident’s life. However, there are still many problems in getting medical services with high quality in some areas, e.g.,inconvenient transportation, lack of medical facilities, poor medical services, and so on. Therefore, it is critical to evaluate the rationality of the distribution of medical resources in a region. Spatial accessibility of medical facilities is an important index to evaluate the rationality of medical service distribution. Among a wide range of methods in measuring the spatial accessibility of facilities, the two-step floating catchment area method(2 SFCA)is most popular. In this study, we analyzed the spatial accessibility of medical facilities in Beibei District,Chongqing, by using the modified two-step floating catchment area method and GIS spatial analysis technology.The modified two-step floating catchment area method takes the scale of hospital grade and the distance between supply and demand points into account, and adds Multi Catchment Sizes and Gaussian distance decay to make up for deficiencies of the traditional two-step floating catchment area method, so it is more widely used in spatial accessibility analysis. The spatial accessibility of medical facilities in Beibei were visualized by spatial interpolation. Moreover, the cluster of spatial accessibility was analyzed by Hot Spot Analysis. The basic unit of analysis was administrative villages. The results show that:(1) The results obtained by the original/unmodified and the modified two-step floating catchment area methods have different characteristics, but the modified takes into account the attraction of hospital scale to residents and the influence of distance attenuation factors to residents travel intention, it has higher sensitivity in identifying high accessibility regions with internal differences and low marginal accessibility regions, so its results can better reflect the spatial accessibility of medical facilities.(2) Overall, the spatial accessibility of medical facilities in Beibei District is high, illustrating that the medical services are more accessible to local residents. Meanwhile, the spatial accessibility of medical facilities in Beibei gradually decreased from central areas to surrounding areas.(3) The spatial accessibility of medical facilities in Beibei District varies greatly with obvious polar differences. The high-value areas are mainly concentrated in Dongyang Street, Chaoyang Street, Tiansheng Street, Beiwenquan Street, and Longfengqiao Street, while the low-value areas are mainly concentrated in marginal areas such as Jindaoxia Town, Liuyin Town, Sansheng Town, Fuxing Street, and Jingguan Town, etc. Our findings can provide reference for the relevant departments to make more informed decision-making.