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基于位置分配模型的医疗机构空间布局优化研究
Spatial layout optimization of medical institutions based on location-allocation modeling

作者:赖国华 刘少坤

单位:南宁,南宁师范大学自然资源与测绘学院

关键词:医疗机构;空间布局;最小化阻抗;卫生服务可达性;医疗保障

分类号:P208; R197

DOI:10.3969/j.issn.2095-7432.2021.01.007

出版年,卷(期),页码:2021,11 (1):22-27

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摘要:

目的 分析广西北部湾沿海城市二级及以上等级的医疗机构空间布局和可达性,拟新增医疗机构提高居民点到达医院的可达性,为政府卫生规划的制定提供参考。方法 运用GIS 软件对区域内33 个二级及以上等级的综合医院,以及124 个乡镇一级居民点,采用OD 成本矩阵分析空间布局现状,基于不同阻抗中断值计算居民点与医疗机构间的可达性,并运用位置分配模型中的最小化设施点模型,在医疗机构空白区确定拟新建医疗机构候选点。结果 二级及以上等级的综合医院集聚于城市中心以及县城中心,处于道路网较为密集的区域,有11 个乡镇在50 000 米内无法到达医院,8 个乡镇在60 分钟内无法到达医院,拟增加9 个医疗点之后医院可达性有了显著提高。结论 城市中心的医疗机构服务范围重叠现象比较严重,偏远地区的居民点到达二级以上的医院距离较远,部分居民点的紧急就医无法保障,未来医疗资源应实现地理空间优化配置,满足居民的医疗卫生需求。

英文摘要:

Objective To analyze the spatial layout and accessibility of secondary or tertiary medical institutions in coastal cities of Beibu Gulf, Guangxito provide reference for government health planning. Methods Using the GIS software, we analyzed the current spatial layout of 33 secondary and tertiary general hospitals and 124 township-level residential areas with the OD cost matrix. The accessibilities for residential areas to medical institutions were calculated based on different impedance cutoff values. The minimized

facility point in the location-allocation model was used to identify candidate sites for new healthcare providers to be established in the medical institution blank areas. Results Secondary and tertiary general hospitals were clustered in the central areas of cities and counties with dense road networks. Residents in eleven townships were inaccessible to hospitals within 50,000 m and in 8 townships were inaccessible to hospitals within 60 min, and the accessibility of hospitals has been significantly improved after the proposed addition of 9 medical facilities. Conclusions The servicing areas of medical institutions are overlapped in central areas of cities, and the distance to the secondary and tertiary hospitals is long in remote areas. The emergency medical service is not available in some residential areas. Therefore, the spatial layout of medical resources should be further optimized to meet the healthcare needs of residents.

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