Yang Yu, Wang Yong
State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
Int J Environ Res Public Health. 2022 Mar 9;19(6):3227. doi: 10.3390/ijerph19063227.
When medical diagnostic difficulties occur at local hospitals, seeking high-quality services across regions becomes a priority for many patients. Traditional statistical methods in health care are unable to account for spatial characteristics such as outflow place or distributions of disease type and patient ages in the context of an increasing number of cross-regional groups; thus, these methods are incapable of studying service utilization differences among hospitals. From a geographic perspective, we analyzed the spatial characteristics of cross-regional patient groups who travelled from other places to Beijing and the spatial decay patterns in the actual service utilization of different hospitals in Beijing by using geographic calculations, geographic visualizations, and distance decay functions. We found the following results: (1) It is feasible to study patients' cross-regional mobility from a geographical perspective. Through interdisciplinary integration, we can explore laws and conclusions that cannot be examined by traditional statistical methods in health care. (2) The characteristics of cross-regional patients who travelled from other places to Beijing were as follows: (a) Most patients came from northern China, and neoplasm treatment was the main demand of cross-regional patients; (b) patients 40-65 years old were the main cross-regional treatment group, and the average age of patients from northern regions and certain eastern coastal cities was relatively high. (3) The exponential distance decay function was the best of all five distance decay functions in fitting the distribution of cross-regional patient mobility to hospitals of different levels, types, and functional areas. The results of applying this function and the centrality calculation method showed that hospital service utilization was least affected by distance and that average radial distances (AR) were greatest in tertiary hospitals (distance decay coefficient = 0.0786, AR = 664.70 km), traditional Chinese medicine hospitals ( = 0.0752, AR = 743.52 km), and hospitals in urban extension areas ( = 0.0782, AR = 693.29 km). Our results can serve as a reference for research concerning the allocation of medical resources and patients' choices regarding medical treatment.
当地方医院出现医疗诊断困难时,跨地区寻求高质量医疗服务成为许多患者的首要选择。在跨地区就医群体日益增多的背景下,医疗保健领域的传统统计方法无法考虑诸如流出地、疾病类型分布和患者年龄等空间特征;因此,这些方法无法研究不同医院之间的服务利用差异。从地理学角度出发,我们运用地理计算、地理可视化和距离衰减函数,分析了从外地来北京就医的跨地区患者群体的空间特征以及北京不同医院实际服务利用中的空间衰减模式。我们得到了以下结果:(1)从地理学角度研究患者的跨地区流动是可行的。通过跨学科整合,我们可以探索传统医疗保健统计方法无法检验的规律和结论。(2)从外地来北京就医的跨地区患者具有以下特征:(a)大多数患者来自中国北方,肿瘤治疗是跨地区患者的主要需求;(b)40 - 65岁的患者是主要的跨地区治疗群体,来自北方地区和东部沿海某些城市的患者平均年龄相对较高。(3)在拟合不同级别、类型和功能区医院的跨地区患者流动分布方面,指数距离衰减函数在五个距离衰减函数中表现最佳。应用该函数和中心性计算方法的结果表明,医院服务利用受距离的影响最小,三级医院(距离衰减系数 = 0.0786,平均径向距离(AR)= 664.70公里)、中医医院( = 0.0752,AR = 743.52公里)和城市扩展区医院( = 0.0782,AR = 693.29公里)的平均径向距离最大。我们的研究结果可为医疗资源配置及患者就医选择的研究提供参考。