Sun Chengshuang, Zhou Ke, Li Guangxia, Zhu Weina, Wan Dongjun
School of Economics and Management Engineering, Beijing University of Civil Engineering and Architecture, Beijing, China.
PLoS One. 2025 Apr 9;20(4):e0319638. doi: 10.1371/journal.pone.0319638. eCollection 2025.
The frequent occurrence of various urban disasters poses risks to human survival and welfare, and it is of great significance to evaluate the urban medical system carrying capacity (UMSCC), monitor the spatial and temporal patterns of the UMSCC and identify their obstacle factors to improve the public medical system and rationalize medical resource allocation. In this paper, the Yangtze River Delta urban agglomeration (YRDUA), which includes 27 major cities, is taken as a case study. A UMSCC evaluation model is constructed and the gravity center shift trajectory is analyzed by using the ArcGIS software. The results indicate that the UMSCC of the 27 cities in the YRDUA can be classified into 5 levels: the lowers (0.193-0.335), the lows (0.335-0.425), the mediums (0.425-0.489), the highs (0.489-0.549) and the highers (0.549-0.619). From 2011-2021, the UMSCC level in all the 27 cities from the YRDUA increased annually, and during this period, the gravity center of the UMSCC was concentrated in Xuancheng, and the migration trend was southwest. Moreover, there is a positive correlation between the city type and the level of UMSCC: the larger of the city is, the higher of the UMSCC level is; however, the gap between the levels of UMSCC in different city types in the YRDUA gradually narrows and tends to be consistent, which reflects the development trend of medical system integration in the region. Finally, it is concluded that the key obstacle indicators of the UMSCC in the YRDUA can be attributed to the proportion of medical financial expenditure, the number of beds, the number of registered nurses and the urban digital development level. Correspondingly, the suggestions are proposed.
各类城市灾害的频繁发生对人类生存和福祉构成风险，评估城市医疗系统承载能力（UMSCC）、监测UMSCC的时空格局并识别其障碍因素，对于完善公共医疗体系和合理配置医疗资源具有重要意义。本文以包括27个主要城市的长江三角洲城市群（YRDUA）为例进行研究。构建了UMSCC评估模型，并利用ArcGIS软件分析了重心转移轨迹。结果表明，YRDUA中27个城市的UMSCC可分为5个等级：低（0.193 - 0.335）、较低（0.335 - 0.425）、中等（0.425 - 0.489）、较高（0.489 - 0.549）和高（0.549 - 0.619）。2011 - 2021年，YRDUA中所有27个城市的UMSCC水平逐年上升，在此期间，UMSCC重心集中在宣城，迁移趋势为西南方向。此外，城市类型与UMSCC水平之间存在正相关关系：城市规模越大，UMSCC水平越高；然而，YRDUA中不同城市类型的UMSCC水平差距逐渐缩小并趋于一致，这反映了该地区医疗系统一体化的发展趋势。最后得出结论，YRDUA中UMSCC的关键障碍指标可归因于医疗财政支出比例、床位数、注册护士人数和城市数字化发展水平。并相应地提出了建议。
