老龄化视域下县域优质医疗资源空间可达性研究

Spatial accessibility of premium medical resources at the county level from the perspective of aging population

目的探讨县域优质医疗服务的均等化问题,以期为保障老年人口健康需求,促进老年人口高质量发展提供参考。方法运用两步移动搜索法和空间计量模型,以全国县(区)为研究单位(港澳台未统计),探究我国老年人口医疗资源的空间可达性及其影响因素。结果基于老年人的全国三级甲等医院可达性存在显著的空间差异,省会城市中心城区的老年人获取优质医疗资源的便捷性较好。空间可达性的分布沿着“东部地区—中部地区—东北地区—西部地区”扩散递减,且地区间差异较大。从影响因素来看,医疗卫生支出、人均可支配收入、抚养比、城镇化率水平、公共汽(电)车拥有量对地区老年人获取优质医疗资源均有不同程度的重要影响。结论应加快优质医疗资源扩容下沉,促进优质医疗资源区域间均衡分布,从而提升优质医疗资源空间可达性。

Objective To investigate the equitable distribution of premium healthcare services at the county level,providing references for meeting the healthcare demands of the aging population and the high-quality development of elderly care.Methods Utilizing the two-step floating catchment area method and spatial econometric modeling,this study examined the spatial accessibility and determinants of healthcare resources for the elderly in counties/districts across China's Mainland(not including Hong Kong SAR,Macao SAR,and Taiwan Province).Results There were significant spatial differences in the accessibility of tertiary hospitals among the elderly.The elderly living in the central urban area of provincial capitals had better access to premium medical resources.The spatial accessibility of medical resources was highest in eastern China,followed by the central and northeast regions,and was lowest in western China.The differences were significant among different regions.Health care expenditure,per capita disposable income,dependency ratio,urbanization rate,and bus(tram)service availability were important factors influencing the access to premium medical resources by the elderly.Conclusion Accelerating the outreach and sinking of premium medical resources will promote the balanced distribution of premium medical resources among regions and thus improve the spatial accessibility of these resources by the elderly.