Spatial Accessibility Of Medical Service And Analysis Of Resource Allocation In Lanzhou

In order to promote the fairness and justice of medical treatment for residents and adhere to the fairness and efficiency of medical service supply,this paper selected the representative provincial capital Lanzhou city in the northwest region as the study area based on the social problems such as unreasonable structure and uneven distribution of health resources,which were put forward in the medical reform during the 13 th fiveyear plan period.From the perspectives of space and demand to evaluate spatial accessibility of medical service,to analyze medical resources allocation situation,to research the accessibility of emergency medical services and optimization of emergency resource allocation.And reveal the problems existing in the medical service present situation of Lanzhou,put forward suggestions for medical resources allocation planning.Methods include: Evaluating the spatial accessibility of medical services through Modified 2SFCA;Evaluating the fairness of medical resources allocation based on Gini coefficient and Lorentz curve;Adopting the method of statistical calculation and comparison to calculate relationship between the supply and the demand.GIS spatial analysis was used to analyze the accessibility of emergency medical services and the impact of traffic congestion on accessibility.Location-allocation model was used to propose the optimization scheme of emergency medical resource allocation.The research found that:(1)Areas in General and below grade of accessibility account for most of Lanzhou city.Therefore,the spatial accessibility of whole Lanzhou city is comparatively unsatisfactory.It shows a tendency of the north region to be worse than south region,and areas in parts of the main districts,parts of Honggu district,and other tiny minority show Great grade of accessibility,and most of other areas distribute in poorer grade of accessibility,especially the surrounding mountainous region.(2)There are obvious differences in accessibility between urban and rural regions,mainly reflected in that residents and areas are basically districted in the Great and Good grade in the urban region,while 64.5% of the population and 24.2% of the areas are distributed in the Great and Good grade,and nearly 35.5% of the residents and 75% of the areas are still in the unsatisfactory accessibility grade in the rural region.(3)The spatial difference of medical resource allocation in Lanzhou is obvious.From the perspective of demand,outpatient services cannot meet the needs of most residents.The areas with serious imbalance between supply and demand are concentrated in Yongdeng county and Yuzhong county.Inpatient service can meet the needs of most residents.The imbalance between supply and demand occurs in Yongdeng county urban area.Currently,medical resources offer to covid-19 in Lanzhou can meet the demand under the incidence in Gansu province and Lanzhou city,and there is an imbalance between supply and demand under the incidence in Wuhan city and Hubei province.From the perspective of supply,the imbalance between the supply and demand of outpatient services in grade hospitals exceeds 80%,and the balance between the supply and demand of most basic medical facilities can be achieved.The imbalance between the supply and demand of inpatient services is mainly reflected in secondary hospitals.There are also big differences in the allocation of medical resources between urban and rural areas.(4)Medical resources are distributed fairly according to population and unfairly according to geographical area.Bed resources according to the population distribution of the Gini coefficient is 0.1830,medical technican resources according to the population distribution of the Gini coefficient is 0.2461.Bed resources according to the geographicarea of the Gini coefficient is 0.6106,medical technican resources according to the geographical area of the Gini coefficient is 0.6080.From the Gini coefficient analysis,medical resources according to the population distribution between urban and rural difference is small and that between urban and rural areas is larger according to geographical area.(5)Traffic congestion affects the accessibility of pre-hospital emergency services.The average and maximum time required for residents to obtain pre-hospital emergency services in peak period increased by 10.6% and 14% respectively compared with that in normal peak period.(6)Allocation of emergency medical resources is unreasonable.The distribution of emergency stations is too concentrated,and the service areas formed by each station overlap a large area.