基于网络地图导航数据，测量中国西部陕西省县级医院的空间可达性和省内可达性差异。

Measuring spatial accessibility and within-province disparities in accessibility to county hospitals in Shaanxi Province of Western China based on web mapping navigation data.

机构信息

School of Public Policy and Administration, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, 710049, Shaanxi, China.

Team IETO, Bordeaux Population Health Research Center, University de Bordeaux, 33076, Bordeaux, France.

出版信息

Int J Equity Health. 2020 Jun 18;19(1):99. doi: 10.1186/s12939-020-01217-0.

DOI:10.1186/s12939-020-01217-0

PMID:32552715

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7302366/

Abstract

BACKGROUND

The Chinese government proposed the "XIAO BING BU CHU CUN, DA BING BU CHU XIAN" initiative in 2016, which states the rate of health care service provided by county hospitals should reach 90% of overall health care service provision. The prerequisite for achieving this goal is that citizens should be able to access county hospitals' services conveniently and impartially. However, little research has been done on the actual levels of the spatial accessibility of citizens to county hospitals in Western China. Therefore, we aimed to measure the spatial accessibility to county hospitals for county residents and to identify any regional disparities in Shaanxi Province in Western China.

METHODS

We implemented a novel method - involving utilizing navigation data from the AutoNavi web mapping system (knows as Gaode map in Chinese) - to assess the time and distance from villages and neighborhoods to the county hospitals. The navigation data were collected by request through an application-programming-interface using a web crawler (web data extraction tool) in Python. The shortest driving time and distance were extracted from the navigation data. The travel impedance to the nearest provider (TINP) indicator was used to measure spatial accessibility.

RESULTS

The results show that county residents in Western China's Shaanxi Province have poor spatial accessibility to county hospitals. Only 68.8% of villages and neighborhoods are within 60 min travel time (based on driving mode) to a county hospital, while 13.4% of such villages and neighborhoods are beyond 90 min travel time. Moreover, a significant within-province disparity exists, with residents in the central area enjoying the best accessibility to county hospitals, while the northern and southern areas still need improvements in accessibility.

CONCLUSIONS

Focused health resource planning is required to improve the spatial accessibility to county hospitals and to eliminate regional disparities. Further studies are called for to integrate the navigation data of web mapping systems with GIS methods to the measure spatial accessibility of health facilities in more complex contexts.

摘要

背景

2016 年，中国政府提出了“小病不出村，大病不出县”的倡议，要求县级医院提供的医疗服务比例应达到总医疗服务的 90%。实现这一目标的前提是居民能够方便、公平地获得县级医院的服务。然而，关于中国西部地区居民到县级医院的实际空间可达性水平，相关研究甚少。因此，我们旨在衡量县级居民到县级医院的空间可达性，并确定中国西部地区陕西省的区域差异。

方法

我们采用了一种新方法——利用高德地图（AutoNavi 网络地图系统的中文名称）的导航数据——来评估村庄和社区到县级医院的时间和距离。通过使用 Python 中的网络爬虫（网络数据提取工具）通过应用程序编程接口请求收集导航数据。从导航数据中提取最短驾驶时间和距离。使用最近提供者的可达性衡量指标（TINP）来衡量空间可达性。

结果

结果表明，中国西部地区陕西省的县级居民到县级医院的空间可达性较差。只有 68.8%的村庄和社区在 60 分钟的车程内（基于驾驶模式）到达县级医院，而 13.4%的村庄和社区则需要 90 分钟以上的车程。此外，省内还存在显著的差异，中心区域的居民享有最好的县级医院可达性，而北部和南部地区的可达性仍有待提高。