Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, 210023, China.
State Key Laboratory Cultivation Base of Geographical Environment Evolution (Jiangsu Province), Nanjing, 210023, China.
Int J Equity Health. 2017 Nov 28;16(1):206. doi: 10.1186/s12939-017-0702-z.
Southwest China is home to more than 30 ethnic minority groups. Since most of these populations reside in mountainous areas, convenient access to medical services is an important metric of how well their livelihoods are being protected.
This paper proposes a medical convenience index (MCI) and computation model for mountain residents, taking into account various conditions including topography, geology, and climate. Data on road networks were used for comprehensive evaluation from three perspectives: vulnerability, complexity, and accessibility. The model is innovative for considering road network vulnerability in mountainous areas, and proposing a method of evaluating road network vulnerability by measuring the impacts of debris flows based on only links. The model was used to compute and rank the respective MCIs for settlements of each ethnic population in the Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province, in 2009 and 2015. Data on the settlements over the two periods were also used to analyze the spatial differentiation of medical convenience levels within the study area.
The medical convenience levels of many settlements improved significantly. 80 settlements were greatly improved, while another 103 showed slight improvement.Areas with obvious improvement were distributed in clusters, and mainly located in the southwestern part of Yingjiang County, northern Longchuan County, eastern Lianghe County, and the region where Lianghe and Longchuan counties and Mang City intersect.
Development of the road network was found to be a major contributor to improvements in MCI for mountain residents over the six-year period.
中国西南地区拥有 30 多个少数民族。由于这些人口大多居住在山区，因此能否方便地获得医疗服务是其生计得到保障的重要指标。
本文提出了一种针对山区居民的医疗便利指数（MCI）和计算模型，考虑了地形、地质和气候等多种条件。利用道路网络数据，从脆弱性、复杂性和可达性三个角度进行了综合评价。该模型创新性地考虑了山区道路网络的脆弱性，并提出了一种基于链路测量泥石流影响来评估道路网络脆弱性的方法。该模型用于计算和排名云南省德宏傣族景颇族自治州各民族人口聚居地在 2009 年和 2015 年的各自 MCI。还利用两个时期的居民点数据，分析了研究区内医疗便利水平的空间差异。
许多居民点的医疗便利水平显著提高。其中 80 个居民点得到了极大改善，另外 103 个居民点略有改善。明显改善的地区呈聚集分布，主要分布在盈江县西南部、陇川县北部、梁河县东部以及梁河县和陇川县与芒市交界处。
道路网络的发展被认为是山区居民 MCI 在六年内得到改善的主要因素。
