福州市医疗卫生机构可达性的空间格局及影响因素

Spatial Pattern and Influencing Factors of Accessibility to Medical Institutions in Fuzhou City

基于空间生产理论,采用福州市74个乡镇街道的多源数据,运用改进的两步移动搜索法和空间自相关法测度了该市不同交通方式下不同层级医疗卫生机构的可达性格局,并利用地理探测器分析了物质空间、精神空间、社会空间及三元空间交互的影响。结果表明:(1)福州市医疗卫生机构可达性的空间分异和空间集聚特征显著,优质医疗资源配置的城郊差距较大,基层医疗资源配置的邻里差距较大,交通机动化促进了医疗资源的空间均衡性。(2)医疗卫生机构可达性格局由建成环境、制度管治、社会结构等多重因素塑造,制度结构对空间的塑造往往最为直接和强烈,三元空间的交互作用大于单一作用。

Based on space production theory,this paper applied multi-source data at neighborhood scale,the improved two-step floating catchment area method,and spatial autocorrelation method to evaluate the accessibility to medical institutions in the central city of Fuzhou.Then the geographical detector method was used to quantitatively identify the effects of physical space,spiritual space,social space and ternary space on shaping the spatial pattern of accessibility.The results showed that:(1)The spatial differentiation and spatial agglomeration of the accessibility to medical institutions in Fuzhou were significant.There was a large gap in the accessibility to high quality medical resources between urban and suburbs,and a large gap in the accessibility to primary medical resources between different neighborhoods.Traffic motorization greatly promoted the spatial balance of medical accessibility.(2)Accessibility to medical institutes was shaped by many factors,such as built environment,institution regulation and social structure.Institutional structure often played the most direct and intense role,and the interaction of ternary spaces was greater than that of single one.