...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>International journal for equity in health >Spatial inequity in access to healthcare facilities at a county level in a developing country: a case study of Deqing County, Zhejiang, China
【24h】

Spatial inequity in access to healthcare facilities at a county level in a developing country: a case study of Deqing County, Zhejiang, China

机译：发展中国家县级医疗机构获得医疗服务的空间不平等：以中国浙江省德清县为例

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background The inequities in healthcare services between regions, urban and rural, age groups and diverse income groups have been growing rapidly in China. Equal access to basic medical and healthcare services has been recognized as “a basic right of the people” by Chinese government. Spatial accessibility to healthcare facilities has received huge attention in Chinese case studies but been less studied particularly at a county level due to limited availability of high-resolution spatial data. This study is focused on measuring spatial accessibility to healthcare facilities in Deqing County. The spatial inequity between the urban (town) and rural is assessed and three scenarios are designed and built to examine which scenario is instrumental for better reducing the spatial inequity. Methods This study utilizes highway network data, Digital Elevation Model (DEM), location of hospitals and clinics, 2010 census data at the finest level – village committee, residential building footprint and building height. Areal weighting method is used to disaggregate population data from village committee level to residential building cell level. Least cost path analysis is applied to calculate the travel time from each building cell to its closest healthcare facility. Then an integral accessibility will be calculated through weighting the travel time to the closest facility between three levels. The spatial inequity in healthcare accessibility between the town and rural areas is examined based on the coverages of areas and populations. The same method is used to compare three scenarios aimed at reducing such spatial inequity – relocation of hospitals, updates of weighting values, and the combination of both. Results 50.03 % of residents can reach a county hospital within 15 min by driving, 95.77 % and 100 % within 30 and 60 min respectively. 55.14 % of residents can reach a town hospital within 5 min, 98.04 % and 100 % within 15 and 30 min respectively. 57.86 % of residential building areas can reach a village clinic within 5 min, 92.65 % and 99.22 % within 10 and 15 min. After weighting the travel time between the three-level facilities, 30.87 % of residents can reach a facility within 5 min, 80.46 %% and 99.88 % within 15 and 30 min respectively. Conclusions The healthcare accessibility pattern of Deqing County has exhibited spatial inequity between the town and rural areas, with the best accessibility in the capital of the county and poorest in the West of the county. There is a high negative correlation between population ageing and healthcare accessibility. Allocation of more advanced medical and healthcare equipment and highly skillful doctors and nurses to village clinics will be an efficient means of reducing the spatial inequity and further consolidating the national medical security system. GIS (Geographical Information Systems) methods have proven successful method of providing quantitative evidence for policy analysis although the data sets and methods could be further improved.
机译：背景中国的地区，城乡，年龄段和不同收入群体之间的医疗服务不平等现象正在迅速增长。平等获得基本医疗保健服务已被中国政府确认为“人民的基本权利”。在中国的案例研究中，医疗机构的空间可及性受到了极大的关注，但由于高分辨率空间数据的可用性有限，因此在县级层面的研究较少。这项研究的重点是衡量德清县医疗设施的空间可及性。评估了城市（镇）和农村之间的空间不平等，设计并构建了三种方案，以检验哪种方案有助于更好地减少空间不平等。方法：本研究利用高速公路网络数据，数字高程模型（DEM），医院和诊所的位置以及2010年最高级的人口普查数据-村委会，住宅建筑物的占地面积和建筑物的高度。地域加权方法用于将人口数据从村委会级别分解为住宅建筑物单元级别。应用最小成本路径分析来计算从每个建筑单元到最近的医疗机构的旅行时间。然后，将通过权衡三个级别之间最接近的设施的旅行时间来计算整体可访问性。基于区域和人口的覆盖范围，研究了城乡之间医疗保健可及性的空间不平等。使用相同的方法比较旨在减少这种空间不平等的三种情况-医院搬迁，加权值更新以及两者的组合。结果驾车在15分钟内可以到达县医院的比例为50.03％，在30分钟和60分钟内分别为95.77％和100％。 55.14％的居民在5分钟内可以到达镇医院，分别在15和30分钟内可以达到98.04％和100％。在5分钟内可以到达乡村诊所的住宅建筑面积为57.86％，在10和15分钟内可以达到92.65％和99.22％。权衡三级设施之间的旅行时间后，30.87％的居民可以在5分钟内到达设施，分别在15和30分钟内达到80.46 %%和99.88％。结论德清县的医疗可及性模式表现出城乡之间的空间不平等，其中县城的可及性最佳，县西部的最贫困。人口老龄化与医疗可及性之间存在高度负相关。向乡村诊所分配更先进的医疗和保健设备以及技术娴熟的医生和护士将是减少空间不平等并进一步巩固国家医疗保障体系的有效手段。尽管可以进一步改善数据集和方法，但是GIS（地理信息系统）方法已被证明是为政策分析提供定量证据的成功方法。

著录项

相似文献

  • 外文文献
  • 中文文献
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号