Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China.
Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China.
复制标题
评估中国四川省少数民族地区就医的空间差异
DOI：
10.1186/s12913-016-1643-8
复制
发表时间：
2016-08-17
影响因子：
2.8
通讯作者：
Pan J
中科院分区：
文献类型：
--
作者：
Wang X;Pan J
背景中国少数民族地区与非少数民族地区就医的空间可及性存在很大差异。作为基本社会诉求之一，少数民族地区就医空间的可及性近年来在中国日益受到关注。我们进行本研究的目的是为了更好地了解我国少数民族地区医院就医的空间可及性，并指导未来政府投资的配置。方法以中国西南部的四川省为样本，考察我国少数民族地区与非少数民族地区医院就医机会的差异。在ArcGIS 9.3环境下应用最短路径分析和增强型两步浮动集水区（E2SFCA）方法。结果在四川，少数民族地区的医疗可及性在就诊时间和空间可达性价值方面均较差于非少数民族地区。在获得医生和卫生专业人员方面的不平等程度比在获得医院床位方面的不平等程度相对更大。与非少数民族地区相比，少数民族地区的一级、二级、三级医院、公立医院与私立医院之间的平衡程度较差。少数民族地区内部的差距大于非少数民族地区。结论最短路径分析与E2SFCA相结合的方法在评估医疗卫生空间可及性方面优于传统的县比法。与非少数民族地区相比，少数民族地区的医疗卫生更加依赖政府投资。少数民族地区目前一、二、三级医院布局不合理，医护人员急缺。因此，我们建议政府利用优惠政策鼓励社会资本加大对少数民族地区的投资，以政府投资作为补充，构建更加公平的医疗市场，鼓励医生到少数民族地区工作，推进农村公路建设。
BackgroundThere is a great disparity in spatial accessibility to hospital care between ethnic minority and non-minority regions in China. Being one of the basic social demands, spatial access to hospital care in minority regions draws increasing attention in China in recent years. We performed this study to have a better understanding of spatial access to hospital care in ethnic minority region in China, and to guide the allocation of government investment in the future.MethodsSichuan Province, southwest of China was selected as a sample to examine the difference in hospital access between ethnic minority and non-minority region in China. We applied the shortest path analysis and the enhanced two-step floating catchment area (E2SFCA) method under ArcGIS 9.3 environment.ResultsIn Sichuan, healthcare access in ethnic minority region is worse than in non-minority region in terms of time to hospital and the value of spatial accessibility. There is relatively greater inequality in access to doctors and health professionals than in access to hospital beds. In ethnic minority region, the balance between primary, secondary, and tertiary hospitals, as well as between public and private hospitals, is less even, compared with the non-minority region. The disparity within ethnic minority region is larger than in non-minority region.ConclusionsThe combination of shortest path analysis and E2SFCA method is superior to the traditional county ratio method in assessing spatial access to healthcare. Compared to the non-minority region, ethnic minority region rely more heavily on government investment to provide healthcare. In ethnic minority region, the current distribution of primary, secondary and tertiary hospitals is inappropriate, and there is an urgent shortage of healthcare personnel. We therefore recommend that the government use preferential policies to encourage more social capital investment in ethnic minority region, use government investment as a supplement to build a more equitable healthcare market, encourage doctors to work in such regions, and push forward road construction in rural area.