突发公共卫生事件下发热门诊配置评价与优化——以哈尔滨市为例

Evaluation and Optimization of Fever Clinic Allocation Under Public Health Emergencies:A Case Study of Harbin

发热门诊作为突发公共卫生事件下保障城乡居民公共健康的重要设施,是筛查、诊断患者的前沿“哨所”和防控“堡垒”。以哈尔滨市为例,采用实际人口分布栅格构建渔网,将其作为更精细化的人口需求数据,对中心城区42家发热门诊的空间布局特征、配置等级数量、服务能力进行评价,并运用改进的高斯两步移动搜索法对中心城区128个街道(乡镇)的发热门诊可达性进行评估。结果表明:①发热门诊呈单中心集聚特征;②发热门诊整体服务能力较好,区域内部均衡度差;③发热门诊可达性具有老城区优于新城区、街道优于边缘乡镇的特点,可达性较好的地区集中分布在城市二环内的老城区,部分边缘乡镇成为防控体系的薄弱区或空白区。结合评估结果划定分区进行配置优化,从丰富监测型医疗类型,构建网络化布局,引入规划技术评估与优化配置,完善医疗基底,提供均等化服务等方面提出优化策略。

As an important facility to protect the public health of urban and rural residents in the event of public health emergencies,fever clinics are the frontier“outpost”and“fortress”for screening and diagnosing patients.Taking Harbin as an example,we construct a fish net using the actual population distribution raster and consider it as a fine population demand data.Then,we evaluate the spatial layout characteristics,number of configuration levels,and service capabilities of 42fever clinics in the central urban area.And the improved Gaussian two-step floating catchment area method is used to evaluate the accessibility of fever clinics in 128 streets(townships)in the central urban area.The results show that,firstly,the fever clinics show a single-center clustering characteristic.Secondly,the overall service capacity of the fever clinics is good,but the internal balance is poor.Thirdly,the accessibility of fever clinics in the old urban area is better than that in the new urban area,and the accessibility of fever clinics in residential districts is better than that in peripheral towns.The areas with good accessibility are concentrated in the old urban area within the second ring road of the city,and some marginal towns have become weak areas or blank areas of the prevention and control system.According to the assessment results,the allocation is optimized by zoning.And the optimization strategy is proposed from the aspects of enriching types of monitoring medical treatment,constructing the network layout,introducing evaluation and optimal configuration of planning technology,improving the medical base,and providing equal services.