Spatial Differentiation and Influencing Mechanism of Medical Care Accessibility in Beijing:A Migrant Equality Perspective

Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all the people proposed by central government of China. Using the spatial analysis and the statistical analysis, this study evaluates the spatial differentiation of medical care facilities accessibility by constructing STT(Shortest Travel-Time) and SAI(Spatial Accessibility Index). And then this study explores the neighborhood effects on the medical care facilities accessibility in Beijing, with a particular focus on the effect of neighborhood migrant proportion by constructing spatial dependent regression model. The spatial accessibility analysis of medical care facilities show that the spatial distribution of medical care facilities was basically consistent with administrative regions but not with population demands. Bivariate LISA cluster maps identify that suburban areas are the overlapped clusters of high percent of migrants and limited medical care services. This is associated with the public service allocation rule in China, which stresses equality within urban areas and within rural areas but overlooks equality between urban areas and rural areas; and stresses local resident demands but overlooks migrant demands. To estimate the effects on medical care accessibility of neighborhood migrant proportion, spatial dependence models are applied due to spatial dependence of accessibility of medical care facilities. The regression results show that neighborhoods with high percent of migrants, even conditioning on neighborhood SES, are related to limited spatial accessibility of medical care services. Besides neighborhood characteristics, another important factor influencing spatial accessibility of medical care services is the process of spatial spillover effects. This indicates that the attenuate accessibility of medical care services for migrants is not only because of their own constraints but also because of their proximity to other disadvantaged neighborhoods. Therefore, it is urgently needed to increase the medical facilities in the suburban areas, to take into account migrants' demands and to reduce residential segregation between local residents and migrants for local governments to achieve the goal of equalization of medical care service.

Rapid report of seismic damage to hospitals in the 2023 Turkey earthquake sequences

The seismic performance of medical systems is crucial for the seismic resilience of communities.The report summarizes the observed damage to twelve hospital buildings in the area affected by the MW 7.8 and MW 7.5 earthquakes on February 6,2023 in Turkey.They include five base-isolated buildings and seven fixed-base buildings in southcentral Turkey's seven most heavily affected provinces.By relating the post-quake occupancy statuses of the hospitals with the estimated seismic demands during the earthquake doublet,the report offers the following observations:(1)the base-isolated hospital buildings on friction pendulum bearings generally exhibited superior performance of achieving the goal of immediate occupancy and provided better protection for nonstructural elements than fixed-base counterparts did;(2)the fixed-base hospital buildings of reinforced concrete structures constructed after 2001 successfully achieved the goal of collapse prevention even under very high seismic demands;(3)some fixed-base hospitals also remained operational even if they were very close to the fault rupture and were subjected to higher-than-design-level earthquake ground motions.

Implementation of safety and security standards for high dose rate brachytherapy sealed radioactive source used in a medical radiation facility

Objective:To provide guidance on basic concepts and elements for radiation safety and security measures for a HDR brachytherapy sealed radioactive source in a medical radiation facility.Methods:Brachytherapy sources are Category 2(High risk-very dangerous)radioactive source and Security Level B applied to cover the range of security measures needed for the associated risk with remote afterloading HDR brachytherapy sources.These security measures were applied based on a risk informed graded approach.A series of in-build and operational safety measures were implemented for equipment and radiation installation.Results:The medical radiation facility equipped with adequate radiation protection,detection and monitoring equipment such as survey meter,digital contamination monitor,gamma zone monitor,digital radiation monitor,personnel dosimeter,pocket dosimeter,long handled forceps,shielding material and emergency source storage container etc.to deal with radiological incidences.The contingency plan with security objectives for incidents and procedures for action was prepared in order to implement response function to fulfill the goal of adequate security of radioactive source.The emergency response plan documented against emergency scenarios during transport,loss of radioactive source,theft,sabotage,natural calamities/disasters such as fire,flood and earthquake.Conculsions:The paper provides various radiation safety and security aspects for the HDR brachytherapy.The HDR brachytherapy radioactive sources are Type A packages.Transport of radioactive material is the responsibility of consignors,consignee and carriers under the legislation,supervision and control of regulatory authority.

分级诊疗制度下的医疗设施可达性研究——以深圳市为例

At present,the hierarchical medical system is widely promoted in China,and the reasonable allocation of medical resources and equal medical services have become important research topics in the field of urban planning.However,it is rare to see studies on the allocation of medical resources from the perspective of spatial accessibility based on the hierarchy of medical facilities and more refined spatial units of population.This research refines the population data from general to residential buildings in urban villages based on census data of buildings.By examining Shenzhen through a 2SFCA(2-step floating catchment area),this research evaluates the accessibility of community and regional medical facilities and the spatial matching at various referral rates by implementing GIS network analysis.The main findings are as follows.(1)The overall development of medical facilities in Shenzhen is currently lagged back among the first-tier cities in China,and there is a discrepancy between administrative districts in terms of the accessibility of medical facilities.(2)Under the current conditions in Shenzhen,the best spatial matching can be achieved only at the referral rate of 70%–80%,indicating weak primary medical resources in Shenzhen.In the future layout and construction of medical facilities,it is necessary to classify and grade the communities and increase the construction of medical facilities in communities with lagging medical standards.In addition,the treatment capacity of community medical services should be improved and the treatment of minor diseases in senior hospitals should be evacuated,so that the referral rate can be controlled at an appropriate level to achieve a balanced allocation and efficient use of medical resources.