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评价中国山东省艾滋病医疗服务的空间可达性和空间布局优化。

Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China.

机构信息

Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.

Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000, Shandong, China.

出版信息

Sci Rep. 2024 May 17;14(1):11258. doi: 10.1038/s41598-024-61484-7.

DOI:10.1038/s41598-024-61484-7
PMID:38755199
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11099158/
Abstract

Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future.

摘要

提高艾滋病医疗服务的可及性是政府和政策制定者关注的重点，他们努力加强整体公共卫生。如何合理分配艾滋病医疗资源，最大限度地实现各社区艾滋病医疗服务的平等可及性，已成为亟待解决的问题。然而，中国在这一领域的研究还很有限。有必要评估空间可达性，以提高艾滋病医疗服务的可及性和公平性。本研究采用改进的多模式两步浮动捕获区（2SFCA）和逆 2SFCA（i2SFCA）方法，测量了中国山东省艾滋病医疗服务的空间可达性和医疗点的拥挤程度。然后，通过最小化需求点之间的可达性差距，计算和可视化理论供应和资源的最优空间分布。研究结果表明，山东省艾滋病服务资源的空间可达性集中且分布不均，地级市边缘地区的可达性得分明显低于其他地区。医生数量较多的地区具有更高的空间可达性。山东省西南部的艾滋病治疗（ART）可达性得分较高。随着旅行摩擦系数的增加，可达性得分形成了一个以地理分布上的医疗点为中心的近似圆形集群分布。在边缘地区需要提供更多的抗逆转录病毒治疗药物，在城市地区需要更多的医生来治疗艾滋病，以解决艾滋病医疗服务空间分布不平衡的问题。本研究深入分析了艾滋病医疗服务的空间可达性，为决策者提供了重要参考。此外，为未来实现艾滋病医疗服务平等可及性的目标提供了重要的探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/0f2e42961959/41598_2024_61484_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/109a75303dbc/41598_2024_61484_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/07a6ae76bf33/41598_2024_61484_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/5fb34bbbfdbf/41598_2024_61484_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/25583a0b293c/41598_2024_61484_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/8ee6f21f17ec/41598_2024_61484_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/0f2e42961959/41598_2024_61484_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/109a75303dbc/41598_2024_61484_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/07a6ae76bf33/41598_2024_61484_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/5fb34bbbfdbf/41598_2024_61484_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/25583a0b293c/41598_2024_61484_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/8ee6f21f17ec/41598_2024_61484_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1aa/11099158/0f2e42961959/41598_2024_61484_Fig6_HTML.jpg

相似文献

[1]
Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China.

Sci Rep. 2024-5-17

[2]
Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs.

BMC Health Serv Res. 2018-5-9

[3]
Hierarchical two-step floating catchment area (2SFCA) method: measuring the spatial accessibility to hierarchical healthcare facilities in Shenzhen, China.

Int J Equity Health. 2020-9-21

[4]
An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare.

Int J Equity Health. 2021-10-19

[5]
Measuring and optimizing the spatial accessibility of primary health care in remote and rural areas: a case study of Liannan Yao Autonomous County in China.

BMC Health Serv Res. 2024-9-19

[6]
Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China.

Int J Environ Res Public Health. 2020-12-26

[7]
Supply-demand adjusted two-steps floating catchment area (SDA-2SFCA) model for measuring spatial access to health care.

Soc Sci Med. 2022-3

[8]
Spatial Inequity of Multi-Level Healthcare Services in a Rapid Expanding Immigrant City of China: A Case Study of Shenzhen.

Int J Environ Res Public Health. 2019-9-17

[9]
Spatial Accessibility to Healthcare Services in Metropolitan Suburbs: The Case of Qingpu, Shanghai.

Int J Environ Res Public Health. 2019-1-15

[10]
Measuring spatial accessibility to healthcare services with constraint of administrative boundary: a case study of Yanqing District, Beijing, China.

Int J Equity Health. 2018-1-15

本文引用的文献

[1]
Trends and prediction in the incidence rate of hepatitis C in Shandong Province in China from 2004 to 2030.

Prev Med. 2023-12

[2]
Inequities in spatial access to health services in Ghanaian cities.

Health Policy Plan. 2023-11-28

[3]
Research Progress in the Epidemiology of HIV/AIDS in China.

China CDC Wkly. 2021-11-26

[4]
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China.

BMC Public Health. 2021-12-4

[5]
Global Health Facility-Based Interventions to Achieve UNAIDS 90-90-90: A Systematic Review and Narrative Analysis.

AIDS Behav. 2022-5

[6]
The spatiotemporal distribution of pre-exposure prophylaxis accessibility in the United States, 2016-2020.

Ann Epidemiol. 2021-12

[7]
Measures of Spatial Accessibility to Healthcare in a GIS Environment: Synthesis and a Case Study in Chicago Region.

Environ Plann B Plann Des. 2003-12

[8]
A systematic review of the effectiveness of non- health facility based care delivery of antiretroviral therapy for people living with HIV in sub-Saharan Africa measured by viral suppression, mortality and retention on ART.

BMC Public Health. 2021-6-10

[9]
Variation in HIV care and treatment outcomes by facility in South Africa, 2011-2015: A cohort study.

PLoS Med. 2021-3

[10]
From 2SFCA to i2SFCA: integration, derivation and validation.

Int J Geogr Inf Sci. 2021

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