Assessing potential spatial accessibility of health services in rural China: a case study of Donghai County.
Assessing potential spatial accessibility of health services in rural China: a case study of Donghai County.
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评估中国农村卫生服务的潜在空间可达性：以东海县为例
DOI：
10.1186/1475-9276-12-35
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发表时间：
2013-05-20
影响因子：
4.8
通讯作者：
Li Z
中科院分区：
文献类型：
--
作者：
Hu R;Dong S;Zhao Y;Hu H;Li Z
前言我国城乡卫生服务差距较大。由于长途旅行而无法获得保健服务的人所占百分比增加。本文以东海县为研究单元，分析了医生短缺地区卫生服务的潜在空间可及性特征。本文分析了卫生服务资源分布不均和新型农村合作医疗制度对东海县卫生服务潜在空间可及性的影响。我们还提出了一些建议，如何缓解在较偏远和孤立的地区的卫生服务的空间可达性不平等。方法从医院到村庄的最短交通时间计算的O-D矩阵的GIS扩展模型。本文应用改进的两步浮动集水区方法（E2 SFCA）对东海县卫生服务的空间可达性进行了研究，并确定了医生短缺地区。使用不同的阻抗系数valuesa的E2 SFCA评估卫生服务的空间可及性的变化的敏感性进行检查。结果东海县有69%的村庄卫生服务潜在空间可达性低于全省平均水平，79%的村庄卫生服务潜在空间可达性低于全省平均水平。从县中心到边远地区，保健服务的潜在空间可及性大大降低。使用较小的阻抗系数会导致那些村庄之间的差距更大。县内公路沿线卫生服务的空间可达性较大，公路沿线沿着为最佳。东海县卫生服务资源分布不均和新型农村合作医疗补偿政策导致了卫生服务空间可及性的边缘效应，即居住在县城边缘的居民获得卫生服务的机会较少。应考虑采取综合措施，缓解较偏远和孤立地区获得保健服务的空间不平等现象。
IntroductionThere is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated.MethodsThe shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services.ResultsThe results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county.ConclusionsMost of villages are in underserved health services areas. An unequal distribution of health service resources and the reimbursement policies of the New Cooperative Medical Scheme have led to an edge effect regarding spatial accessibility of health services in Donghai County, whereby people living on the edge of the county have less access to health services. Comprehensive measures should be considered to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated.
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影响因子：
3
作者：
THOUEZ, JPM;BODSON, P;JOSEPH, AE
通讯作者：
JOSEPH, AE
DOI：
10.1111/j.1440-1584.1998.tb00315.x
发表时间：
1998-11-01
期刊：
The Australian journal of rural health
影响因子：
--
作者：
Humphreys, J S
通讯作者：
Humphreys, J S
影响因子：
2.1
作者：
Lei, Xiaoyan;Lin, Wanchuan
通讯作者：
Lin, Wanchuan
影响因子：
3.4
作者：
Ngui, Andre Ngamini;Vanasse, Alain
通讯作者：
Vanasse, Alain
影响因子：
4.8
作者：
Liu X;Tang S;Yu B;Phuong NK;Yan F;Thien DD;Tolhurst R
通讯作者：
Tolhurst R