| Objectives: This study takes basic medical services in Yueyang City as the research object,and evaluates the geographical accessibility of the primary medical and health institutions in Yueyang City(township health centers and community health service centers that mainly undertake basic medical services).To provide targeted countermeasures and suggestions for promoting the fairness of basic medical services in Yueyang City.Methods:(1)The Auto Navi Map API was used to obtain the time cost data of basic medical services for the residents of Yueyang City by walking and driving during the two travel periods of off-peak and peak respectively.(2)Based on the shortest time method and the Gaussian two-step floating catchment area method,the geographical accessibility of basic medical services in Yueyang City was explored for the two transportation modes of walking and driving,and the two travel periods of off-peak and peak,divided into two research scales: residential area and administrative area.(3)Lorentz curve and Gini coefficient were used to analyze the impact of travel time and traffic mode on the geographical accessibility distribution of basic medical services in Yueyang City.Spatial autocorrelation was used to analyze the spatial correlation and local correlation of geographical accessibility of basic medical services in Yueyang City.Bivariate local Moran index was used to analyze the spatial aggregation and coordination between the geographical accessibility of basic medical services and the population in Yueyang City.(4)Pearson correlation analysis and multiple linear regression were used to analyze the influencing factors of travel time to obtain basic medical services in Yueyang City.Multiple linear regression and geographically weighted regression model were used to explore the influencing factors of geographical accessibility of basic medical care in Yueyang City.Results:(1)In more than 70% of the residential areas,it takes more than an hour to reach the nearest primary medical and health institution on foot,and about 60% of them can reach the primary medical and health institution within 15 minutes by car.(2)The geographical accessibility of basic medical services in the majority of the residential areas is at or below the lower level.In terms of the overall level of geographical accessibility of basic medical services,Yueyanglou District is the highest in the walking mode during off-peak period,and Yunxi District is the lowest;Yunxi District is the highest in the driving mode during off-peak period,and the lowest in Linxiang City;Yueyang County is the highest in the walking mode during peak period,Yunxi District is the lowest;Junshan District is the highest in the driving mode during peak period,and Yunxi District and Linxiang City are the lowest.(3)During off-peak period,the Gini coefficients of the geographical accessibility of basic medical services in Yueyang City for walking mode and driving mode are 0.39 and 0.49,respectively.During peak period,the Gini coefficients for walking mode and driving mode are 0.42 and 0.52,respectively.The geographic accessibility of basic medical services under the four travel modes all showed significant spatial autocorrelation,and the clustering phenomenon of more than half of the communities and villages is not significant.The areas of unequal geographical accessibility and population distribution of basic medical services in Yueyang City are mainly concentrated in the non-agricultural areas of urban and townships in each county-level administrative region and the eastern part of Yueyang City.(4)The shortest travel time to obtain basic medical services is significantly negatively associated with population density and the proportion of the tertiary industry in the walking mode.In the driving mode,the shortest travel time to obtain basic medical services is significantly positively associated with the average gradient.The higher the proportion of the tertiary industry,the smaller the average slope,and the shorter travel time to obtain basic medical services.(5)Overall,the area size,average slope,population density,and population density of the elderly have a negative impact on the geographical accessibility of basic medical services in communities and villages in Yueyang City.Average elevation,road network density,and the number of health technicians have a positive impact on the geographical accessibility of basic medical services.The geographical accessibility of basic medical services in most communities and villages in Yueyang City has a negative association with its average slope and population density of the elderly,and a positive association with its area size and the number of available health technicians.Conclusions:(1)The geographical accessibility of basic medical services in Yueyang City is generally low.(2)The distribution balance of geographical accessibility of basic medical services in Yueyang City is generally poor and the regional differences are obvious.(3)The proportion of the tertiary industry and the average slope are the influencing factors of the shortest travel time to obtain basic medical services in Yueyang City.(4)Average elevation,area size,average slope,road network density,population density,population density of the elderly,and the number of health technicians have an impact on the geographical accessibility of basic medical services in Yueyang City. |
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