China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, China.
School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, China.
Int J Environ Res Public Health. 2019 Jan 15;16(2):225. doi: 10.3390/ijerph16020225.
Spatial accessibility is an important factor for planning healthcare services to maintain a quality life for the metropolitan area. The metropolitan suburb is a special area for its location and rapidly changing population during urbanization. Taking Qingpu district, a suburb of Shanghai as a case, this study evaluated the spatial accessibility to healthcare services of 203 villages and neighborhoods based on the Two-Step Floating Catchment Area (2SFCA) method by ArcGIS software. The result shows that the spatial accessibility in the whole district is quite uneven under lower thresholds, and the spatial differences are beyond the traditional zoning of East Qingpu, New City and West Qingpu. The worst accessibility was mainly distributed at the edges of Jinze, Liantang and Zhujiajiao, while the best accessibility was mainly distributed in the New City and the region close around it. The average value of the spatial accessibility in Qingpu is 2.84, with a reach equal under 90 min threshold by bus index of 2.85, or an under 60 min threshold by self-driving index of 2.70. Secondly, the difference shows a new pattern, that is the spatial accessibility could be affected by both the New City and the Central City. Thirdly, the transportation mode, urbanization, the density of road network and bus lines, as well as the number of doctors in each healthcare service would directly affect the spatial accessibility. Lastly, in order to improve the spatial accessibility in metropolitan suburbs, greater effort is needed in increasing the numbers of bus stations and doctors, especially the areas which are farthest from the New City or the Central City, such as Jinze, and Lian Tang town in Qingpu. We acknowledge that the public transportation is vital to the accessibility to healthcare services. We also emphasize that healthcare services should be planned based on the anticipated future trends of population agglomeration. Our results for Shanghai are applicable to other big cities that are experiencing similar rapid urbanization in China, or other developing countries in Southeast Asia, South Asia, South America and Africa.
空间可达性是规划医疗服务的一个重要因素，对于维持大都市地区的高质量生活至关重要。大都市郊区因其地理位置特殊，且在城市化过程中人口快速变化，是一个特殊的区域。以上海市青浦区为例，本研究采用基于 ArcGIS 软件的两步浮动搜索区域（Two-Step Floating Catchment Area，2SFCA）方法，评估了 203 个村庄和社区的医疗服务空间可达性。结果表明，在较低门槛下，全区的空间可达性极不均匀，空间差异超出了传统的东、新城区和西城区的划分。最差的可达性主要分布在金泽、练塘和朱家角的边缘，而最好的可达性主要分布在新城区及其周边地区。青浦区的空间可达性平均值为 2.84，在公共汽车指数 90 分钟门槛下的可达性为 2.85，或在自驾车指数 60 分钟门槛下的可达性为 2.70。其次，差异呈现出新的模式，即空间可达性既受新城区又受中心城市的影响。第三，交通方式、城市化、路网和公交线路密度以及每个医疗服务机构的医生数量都会直接影响空间可达性。最后，为了提高大都市郊区的空间可达性，需要加大力度增加公共汽车站和医生的数量，特别是远离新城区或中心城市的地区，如金泽和练塘镇。我们承认公共交通对医疗服务的可达性至关重要。我们还强调，医疗服务的规划应基于人口聚集的未来趋势。我们对上海的研究结果适用于中国其他经历类似快速城市化的大城市，或东南亚、南亚、南美洲和非洲的其他发展中国家。
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