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中国特大城市内综合医院可达性的城乡差异。

Urban and rural disparities in general hospital accessibility within a Chinese metropolis.

机构信息

State Key Laboratory of Efficient Utilization of Arid and Semi-Arid Arable Land in Northern China, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing, 100081, China.

Nanjing University of Information Science & Technology, Nanjing, 210044, China.

出版信息

Sci Rep. 2024 Oct 7;14(1):23359. doi: 10.1038/s41598-024-74816-4.

Abstract

Accessibility is one of the crucial criteria for measuring the ease of access to public services in a region. Given China's historical rural-urban dualism and rapid urbanization process, there exist significant disparities in public services within metropolises. This study selects Nanjing as a representative metropolis and employs the Gaussian two-step floating catchment area method and an improved potential model to calculate the accessibility of comprehensive hospitals. Spatial autocorrelation and urban-rural disparities are analyzed, confirming spatial variations in healthcare service equity. The results show that: ①The spatial variability of accessibility to comprehensive hospitals is significant. The Gaussian two-step floating catchment method overestimates overall accessibility, and for Nanjing, the improved potential model with β = 1.5 proves more suitable. ②Accessibility exhibits pronounced clustering characteristics. Healthcare conditions for residents in the northern part of Liuhe District, eastern part of Qixia District, western part of Pukou District, peripheral areas of Jiangning District, eastern part of Gaochun District, and residents in Lishui District need improvement. ③Comprehensive healthcare services are relatively lacking in nearly 60% of rural areas. Our research findings provide valuable insights for improving spatial justice in public infrastructure in metropolises of developing countries.

摘要

可达性是衡量一个地区公共服务可及性的关键标准之一。考虑到中国历史上的城乡二元结构和快速的城市化进程,特大城市内部的公共服务存在显著差异。本研究选取南京市作为典型特大城市,采用高斯两步浮区法和改进的潜力模型来计算综合医院的可达性。分析了空间自相关和城乡差异,证实了医疗服务公平性的空间变化。结果表明:①综合医院可达性的空间变异性显著。高斯两步浮区法高估了整体可达性,而对于南京市,β=1.5 的改进潜力模型更适用。②可达性表现出显著的集聚特征。六合区北部、栖霞区东部、浦口区西部、江宁区周边、高淳区东部以及溧水区居民的医疗条件有待改善。③近 60%的农村地区综合医疗服务相对匮乏。本研究结果为改善发展中国家特大城市公共基础设施的空间公平性提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad54/11458812/2579df4b26cc/41598_2024_74816_Fig1_HTML.jpg

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