Measuring Primary Health Care Accessibility In Jianghan Plain

The results of the spatial allocation of medical services should be able to provide primary health care to local residents equally and efficiently.However,Many developing countries are faced with disparities in the level of urban and rural health and the accessibility of medical services,and medical services can be reached.The access to medical services has become a matter of social justice problem,but the serious mismatch between the "pyramid-type" public health care service system and the "inverted pyramid"of medical needs has led to spatial inequality in public health care facilities.How to measure the level of spatial disparity in medical service resources is an urgent issue to be studied effectively.How to select the best spatial accessibility indicators for assessing the rationality of the allocation of medical service resources is crucial.Based on the National Natural Science Foundation of China(41371183),we choose the typical area of Jianghan Plain,Xiantao Cityof Hubei Province as a case study area,this thesis studied the level of differentiation of the medical service supply and demand levels in the typical region of the Jianghan Plain.The author has completed the following research work:(1)By incorporating the applying the government public data,spatial big data and the investigation data,the database of public health care service of Xiantao City was constructed,which is including administrative division maps,traffic road network,distribution of medical resources,distribution of residents,and traffic data collection.(2)Analysis of the status quo of supply and demand of public health care in Xiantao City,descriptive statistical analysis of medical behavior data sets,analysis of travel mode of traffic data collection,and quantitative measurement of distance decay behavior.(3)From the perspectives of service supply and demand,they respectively assessment the accessibility of residents from the perspective of demand and the assessment of the degree of crowdedness of medical facilities under the supply perspective,and improve designation of health care shortage areas.The work of this thesis is mainly accomplished by the softwares such as ArcGIS 10.3,Office 2016,R studio,Eviews,and Sufer.Spatial analysis,spatial statistics,regression analysis,and descriptive statistics are used to complete relevant calculations and analysis.Research findings:(1)From the analysis of the overall supply and demand status of public health care,it is found that the total medical expenses in 2017 is relatively high inXiantao City,and the medical insurance funds is under high expenditure pressure.(2)The level of primary health care in Xiantao City is insufficient,and the spatial differences in the accessibility of public health care facilities are obvious.The center-perimeter pattern with the county as the core is presented.(3)The crowdedness of medical institutions in Xiantao City is quite different.There is a large gap in medical service resources in rural areas,while urban areas are concentrated in excessive medical resources.The potential congestion degree can be used as an important reference indicator for the differentiation of medical service resources.It can refer to the level of potential congestion of different medical institutions to invest in public resources of a corresponding scale.(4)The three-step floating catchment area method has strong potential in identifying medical shortage areas.The inverted two-step floating catchment area method provides a direct measure of the degree of potential congestion of a facility.Through the effective combination of different methods,it can Business professionals and decision-makers provide comprehensive medical accessibility information and propose scientific and reasonable optimization recommendations to provide strategies for the fair allocation of public facilities.