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评估中国深圳社区层面的医疗资源可达性。

Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China.

机构信息

School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Guangzhou 510080, China.

Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.

出版信息

Int J Environ Res Public Health. 2019 Jan 16;16(2):242. doi: 10.3390/ijerph16020242.

Abstract

Spatial accessibility to medical resources is an integral component of universal health coverage. However, research evaluating the spatial accessibility of healthcare services at the community level in China remains limited. We assessed the community-level spatial access to beds, doctors, and nurses at general hospitals and identified the shortage areas in Shenzhen, one of the fastest growing cities in China. Based on hospital and population data from 2016, spatial accessibility was analyzed using several methods: shortest path analysis, Gini coefficient, and enhanced 2-step floating catchment area (E2SFCA). The study found that 99.9% of the residents in Shenzhen could get to the nearest general hospital within 30 min. Healthcare supply was much more equitable between populations than across communities in the city. E2SFCA scores showed that the communities with the best and worst hospital accessibility were found in the southwest and southeast of the city, respectively. State-owned public hospitals still dominated the medical resources supply market and there was a clear spatial accessibility disparity between private and public healthcare resources. The E2SFCA scores supplement more details about resource disparity over space than do crude provider-to-population ratios (PPR) and can help improve the efficiency of the distribution of medical resources.

摘要

医疗资源的空间可达性是全民健康覆盖的一个组成部分。然而,评估中国社区层面医疗服务空间可达性的研究仍然有限。我们评估了深圳市(中国发展最快的城市之一)社区层面的综合医院床位、医生和护士的可达性,并确定了短缺地区。基于 2016 年的医院和人口数据,我们使用最短路径分析、基尼系数和增强型两步浮动集水区(E2SFCA)等多种方法分析了空间可达性。研究发现,深圳市 99.9%的居民在 30 分钟内可以到达最近的综合医院。城市内部的医疗供应在人口之间比在社区之间更加公平。E2SFCA 得分表明,医院可达性最好和最差的社区分别位于城市的西南和东南。国有公立医院仍然主导着医疗资源供应市场,私人和公共医疗资源之间存在明显的空间可达性差距。E2SFCA 得分比简单的提供者-人口比(PPR)更能补充关于空间资源差距的更多细节,有助于提高医疗资源分配的效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/453c/6352203/b8458e0b686b/ijerph-16-00242-g001.jpg

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