| 引用本文：刘昊鹏, 马骋宇, 杨彦彬, 廖委真, 吕思雨.北京市山区与平原郊区村级医疗服务可达性评价——基于调查的2SFCA研究[J].中国卫生政策研究,2024,17(7):65-74 |
|
| 北京市山区与平原郊区村级医疗服务可达性评价——基于调查的2SFCA研究 |
| 投稿时间：2024-05-15 修订日期：2024-06-21 PDF全文浏览 HTML全文浏览 |
| 刘昊鹏, 马骋宇, 杨彦彬, 廖委真, 吕思雨 |
| 首都医科大学公共卫生学院 北京 100069 |
| 摘要:目的：以北京市怀柔区、门头沟区、通州区为例，评价深山、浅山、平原郊区医疗资源的可达性、公平性，寻找资源配置失衡的影响因素。方法：基于村级卫生调查数据和两步移动搜索法测算样本区医疗服务可达性；结合基尼系数等方法评价资源配置公平性；采用地理探测器和空间滞后模型识别失衡影响因素。结果：怀柔区、门头沟区、通州区可达性均值分别为202.06，179.68，187.02；基尼系数分别为0.48，0.37，0.24；GDP、人口密度、海拔是可达性的显著影响因素。结论与建议：北京市平原与山区村级医疗可达性均呈现主城侧高，郊区侧低的空间聚集现象，平原可达性优于山地。医疗服务公平性平原区＞浅山区＞深山区，医疗机构全覆盖政策对公平性问题有所改善。建议加强村级医疗机构和村医队伍建设，完善县乡村三医联动，提升村民基层首诊意愿；同时，逐步完善交通、网络基础设施建设，提升村民线上线下医疗服务可达性。 |
| 关键词:空间可达性 两步移动搜索法 村卫生室 卫生资源配置 |
| 基金项目:北京市教育委员会科研计划项目(SZ202210025011) |
|
| Accessibility assessment of medical services in suburban plains and mountainous villages of Beijing: An investigation-based 2SFCA study |
| LIU Hao-peng, MA Cheng-yu, YANG Yan-bin, LIAO Wei-zhen, LYU Si-yu |
| School of Public Health, Capital Medical University, Beijing 100069, China |
| Abstract:Objective: This study evaluates the accessibility and equity of healthcare resources in deep mountain, shallow mountain, and plain suburban areas, taking Huairou, Mentougou, and Tongzhou districts of Beijing as examples, to identify factors contributing to the imbalance in resource allocation. Methods: Accessibility of healthcare services in the sample areas was measured using village-level health survey data and the Two-Step Floating Catchment Area (2SFCA) method. Equity of resource allocation was assessed using the Gini coefficient among other methods. Factors influencing imbalance were identified using the Geodetector and Spatial Lag Model. Results: The average accessibility scores for Huairou, Mentougou, and Tongzhou were 202.06, 179.68, and 187.02, respectively. The Gini coefficients were 0.48, 0.37, and 0.24, respectively. GDP, population density, and altitude were significant factors affecting accessibility.Conclusions and Suggestions: In Beijing, both plain and mountainous rural areas exhibited a spatial clustering of healthcare accessibility, higher near the city and lower in the suburbs, with plains performing better than mountains. Healthcare equity was ranked as plains＞shallow mountains＞deep mountains. Policies covering full healthcare services improved equity. It is recommended to strengthen the construction of village healthcare facilities and medical teams, improve the linkage of medical services at all rural levels, and enhance the willingness of villagers to seek primary care. Furthermore, gradual improvement of transportation and internet infrastructure is suggested to enhance the accessibility of online and offline medical services for villagers. |
| Key words:Spatial accessibility Two-step floating catchment area method Village clinic Health resource allocation |
| 摘要点击次数: 675 全文下载次数: 182 |
|
|
|
|
|
