Measuring the healthcare spatial deprivation in multiple perspectives: a case study of Ningbo city

IF 2.4 Q3 ENVIRONMENTAL SCIENCES
Yue Qian, Guanmin Qiao, Tonglu Li, Renfeng Ma
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Abstract

Background Equalization of medical servic e s is fundamental to the development of people-centered urbanization in Chinese-style modernization. In the past few decades, the achievements of the Chinese economy have remarkably increased the quantity and quality of healthcare services. Under rapid urbanization, large-scale population floating has led to a mismatch between supply and demand for healthcare services and raised the tension between spatial demographic reorganization and the relative stability of public healthcare service facilities. The current studies of healthcare spatial deprivation (HSD) mainly are focus on either supply, or demand, or accessibility based on census data. Therefore, it is necessary to build a multiple index that could give a physical result by using ordinary indices and mixing them together by relative methods to overcome this problem. Measure We chose Ningbo city, Zhejiang province, located in the eastern coastal region of China, as the study area. Moreover, from 2000 to 2020, the urbanization rate of Ningbo rapidly increased from 55.75 to 78.0%. In order to show the HSD in a rapidly urbanizing city, we first consider the subdistrict as the scale, innovatively absolve the medical accessibility to the IRD (Index of Relative Disadvantage), and construct the Index of Healthcare Relative Spatial Deprivation (IHRSD) framework. Based on the seventh national census data, we apply an IHRSD with Entropy Weight Method, 2SFCA (Two-step Floating Catchment Area Method) and GDM (Geographical Detector Model) to measure where and who are vulnerable to deprive in healthcare. Result Measured by IHRSD, (1) There is stronger healthcare spatial deprivation in peri-urban and developed-town in Ningbo; (2) Young childhood and fertile-women are vulnerable to healthcare spatial deprivation, in fact, they are spatially deprived in healthcare; (3) The socio-demographic attribute is a significant factor in healthcare spatial deprivation, especially the level of aging and population clustering; and (4) The relationship between healthcare spatial deprivation and accessibility shows an inverted U -shaped structure. Conclusion Our experiments show that the problems of HSD are mainly from the characteristics of the population, the layout of healthcare service institutions, the accessibility of the traffic system and the natural conditions. Although the constructions of equalization of primary medical and health services, hierarchical diagnosis, and treatment, and the “healthcare complex” are currently trying to reduce the phenomenon of HSD. Faced with groups and location, the acquisition of the accurately healthcare service supply is the key to realizing healthcare spatial equity.
多维视角下的医疗卫生空间剥夺测度——以宁波市为例
医疗服务均等化是中国式现代化以人为本的城镇化发展的基础。在过去的几十年里,中国经济的成就显著提高了医疗服务的数量和质量。在快速城市化的背景下,大规模的人口流动导致了医疗卫生服务的供需不匹配,加剧了空间人口结构重组与公共医疗卫生服务设施相对稳定之间的紧张关系。目前对医疗空间剥夺的研究主要集中在基于人口普查数据的供给、需求或可及性方面。因此,为了克服这一问题,有必要利用普通指标,并通过相对的方法将它们混合在一起,建立一个能够给出物理结果的多重指标。我们选择位于中国东部沿海地区的浙江省宁波市作为研究区域。从2000年到2020年,宁波市城镇化率从55.75%快速提高到78.0%。本文首先以街道为尺度,创新地将医疗可及性纳入相对劣势指数(IRD),构建医疗相对空间剥夺指数(IHRSD)框架,以反映快速城市化城市的医疗相对空间剥夺。基于第七次全国人口普查数据,应用熵权法、两步浮动集水区法和地理检测器模型(GDM)相结合的IHRSD来衡量医疗保健中哪些地区和哪些人容易被剥夺。结果IHRSD测量结果表明:(1)宁波市城郊和发达城镇存在较强的医疗卫生空间剥夺;(2)幼儿期和育龄妇女易遭受卫生保健空间剥夺,实际上是卫生保健空间剥夺;(3)社会人口属性是影响医疗卫生空间剥夺的重要因素,尤其是老龄化水平和人口集聚程度;④卫生保健空间剥夺与可达性呈倒U型关系。结论HSD的问题主要来自人口特点、医疗卫生服务机构布局、交通系统可达性和自然条件。虽然初级医疗卫生服务均等化、分级诊疗和“保健综合体”的建设目前正在试图减少HSD现象。面对群体和区位,精准医疗服务供给的获取是实现医疗空间公平的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.00
自引率
7.10%
发文量
176
审稿时长
13 weeks
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