| Objective:Analyze spatial accessibility and fairness of medical services in Guangxi through spatial analysis,understand the status quo of spatial accessibility of medical services in Guangxi,evaluate its fairness,and analyze the causes of this distribution,provide a scientific reference for the spatial layout of medical services in Guangxi.Method:Analyze the accessibility of medical resources in Guangxi by means of the proportional method,spatial nearest neighbor in the nearest distance method,Tyson variable shape,buffer in the opportunity accumulation model,gravitational model and improved gravitational model,and use the interpolation analysis to reach visualization of sexuality index.Analysis methods of fairness of medical service accessibility in Guangxi include global spatial autocorrelation,local spatial autocorrelation analysis(Moran’s I),global hot spot analysis,local hotspot analysis(Getis-Ord),Gini coefficient,Lorenz curve and the fairness of the allocation of medical resources.Result: 1.Proportional method: In 2016,the Guangxi region had an average of 4.24 beds per 1,000 people and 0.86 beds per square kilometer.The average resources of each region are different,and the geographical distribution of thousands of people in urban areas show higher than in rural areas.The areas along the railway are higher than other areas;the distribution of the number of beds per square kilometer in the urban areas is also higher than in the rural area,and the densely populated areas in the southeast are higher than other areas;2.The nearest distance method: 2.1 Space Nearest Neighbourhood: In the nearest secondary hospitals and the shortest distance maps in residential areas,the shortest distance to secondary hospitals is relatively short in central Guangxi.Secondary hospitals have better medical accessibility.While in the northwest,the shortest distance to secondary hospitals is relatively long.Those secondary hospitals have poor medical accessibility.The third-tier hospitals in central and southwestern Guangxi in the shortest distance maps are relatively shallow,and the shortest distance from those hospitals is relatively short.Third-tier hospitals have better medical accessibility,while the northwest regions have line colors.Relatively deep.2.2 Tyson’s Deformation: The number of the largest service population in secondary hospitals reached 743,500 people,with a minimum of 8,676 people.The largest population of services in the tertiary hospital reached 2,988.8 thousand people,with a minimum of 70.Mainly concentrated in the southeast of Guangxi,the three-tier hospital Tyson polygon diagram in each area is not obvious color distinction,but Tyson polygon area differences.The service population of tertiary hospitals in the 70-277362 level is 50.11% and the service population is only 6.47%,while the serving population is only 12.35% in the service level of 161805-128168331.At 35.08%,secondary hospitals showed the same distribution.3.Cumulative opportunity model: The 10 km buffer zone of the Grade II hospital covers 43.04% of the population and covers only 14.58% of the area;88.79% of the residents can find at least one secondary hospital within 30km; the second hospital can have 60 km of buffer within the buffer.It covers 99.70% of the population in Guangxi and 99.33% of the area.The 20 km buffer zone of the tertiary hospital covers 22.99% of the population and covers only 8.49% of the area;83.98% of the residents can find at least one tertiary hospital within 80km;the tertiary hospital can cover 98.57% of Guangxi’s total within 140 km of the buffer zone.Population and 96.89% of the area.4.Gravity model: The areas with high accessibility values are mainly concentrated in the urban areas of the cities and the surrounding counties of Nanning,Liuzhou,Guilin,Yulin,etc.;while the low value areas are mainly distributed in the southwestern regions of northern Guangxi and Hechi.A logarithmic transformation of the accessibility value was found to coincide with the distribution of secondary and tertiary hospitals in Guangxi,indicating that the impact of distance on accessibility exceeded that of the competing population in this study.5.Non-spatial perspective equity analysis: In 2016,the Gini coefficient of the population perspective of the medical institutions in Guangxi was 0.14,and the Gini coefficient of Guangxi medical institutions in the geographical view of beds was 0.32.The Gini coefficient of population distribution is less than geographical distribution.The population distribution and Gini coefficient are within the fairness line,while the geographically distributed Gini coefficient is relatively fair.6.Analysis of the fairness of spatial perspective: A global spatial autocorrelation analysis was conducted on the spatial values of accessibility and accessibility of Guangxi residents,and it was found that there was a statistically significant positive correlation between the two indicators within the region, indicating that the two indicators The spatial distribution is not random and presents a certain aggregation phenomenon.The global hotspot of the reachability value analysis General G index is positive,and Z>1.96,P<0.05 indicates that the reachability value has a high value clustering phenomenon.Conclusion:The accessibility of Guangxi residents to hospitals is not balanced and there is spatial aggregation.Nanning,Liuzhou,and Guilin are the high-value agglomeration areas,while the western areas of Baise,the southwest of Hechi,and the junction of Yulin,Beihai and Qinzhou are low-value gathering areas for accessibility,and these areas are also relatively poor.area.It is necessary to limit the expansion of medical service resources in high-value areas and avoid waste of unnecessary medical service resources.For low-value areas,it is necessary to increase the intensity of assistance to these areas and combine with China’s medical poverty alleviation policies to enable the medical service capabilities of county-level hospitals in poor counties.At least one hospital in a poverty-stricken county should be reach level a second-tier hospital,giving full play to the role of the county-level medical center and providing effective basic medical and health services to the residents of impoverished counties.GIS analysis method has great operability in the field of allocation of health resources.It can intuitively reflect the relative geographical distribution of medical institutions and residential areas,as well as the service coverage of medical institutions and surrounding medical institutions in residential areas.The location through the calculation of reachability values and visual representation of the actual situation of accessible residential space for all residential points;through the analysis of fairness of accessibility can be a better identification of resource-rich areas(hot spots)And resources shortage area(cold area).GIS technology has great potential in health resource allocation and health resource planning... |
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