| Objective In this study,GIS was applied to analyze the allocation and utilization of obstetrical beds and the accessibility of midwifery institutions,and then to evaluate the rationality of the allocation and utilization of obstetric beds and the layout of midwifery institutions in monitoring districts.The factors that may affect the allocation of obstetrical beds in districts were tested.In all,this study was expected to provide references for rational allocation of obstetrical beds in monitoring districts.Methods Through sorting the demographic econometric indicators of the 2016 Statistical Yearbook of Wuhan,Chengdu and Shenzhen,this study described the basic conditions of the monitoring districts;This study used ArcMap to draw the statistical maps of allocation and utilization of obstetrical beds in different districts and counties in order to describe the situation of allocation and utilization of obstetrical beds;This study calculated the population-weighted distance of census-tract,districts and cities respectively to measure the accessibility to midwifery institutions;This study aimed to take the density of obstetrical beds in Chengdu as dependent variable and the demographic econometrics indicators as independent variables,and use classical OLS regression and spatial autoregressive to test the factors which may influence the hospital beds allocation.Results In 2016,the monitoring districts had a total population of 37 million,with about 2,270,000 square kilometers area,280 midwifery institutions,577663 total live births,and 10,721 open beds.Except that the beds allocation of Hong Shan District was insufficient based on live birth,the rest districts and counties was sufficient.The total utilization rate of beds in Hong Shan District and Han Nan District of Wuhan was higher than 93%.The beds utilization rate of public tertiary of Hong Shan District and public secondary of Han Nan District was 121.8%and 95.7%,respectively.The total utilization rate of bed of Jiang Han District,Qing Shan District,Jiang Xia district and other counties was low.The beds utilization rate of public tertiary of Qiao Kou District and Wu Chang District was higher than 93%.The beds utilization rate of public secondary,primary and private midwifery institutions(except Han Nan District)was all below 62%.The beds allocation of Ping Shan New District and Yan Tian District was better based on live birth than on population.The beds of Luo Hu District,Fu Tian District and Nan Shan District was well allocated based on population but not sufficient based on live birth.The beds allocation of Guang Ming New District was poor based on either live birth or population.The beds allocation of the rest was sufficient based on both live birth and population.The total utilization rate of beds in Fu Tian District and Guang Ming New District was higher than 93%.The total utilization rate of beds in Da Peng New District and Ping Shan New District was lower,which was 24.8%and 55.4%respectively.The beds utilization rate of public tertiary of Luo Hu District,Bao An District and Long Gang District was higher than 100%.The beds utilization rate of public secondary of Luo HuDistrict and Nan Shan District was higher than 90%.The beds utilization rate of public primary and unknown-rank of Luo Hu District,Yan Tian District and Da Peng New District was lower than 40%.The beds utilization rate of private midwifery institutions(except Guang Ming New District)was all lower than 80%.The beds allocation of Jin Jiang District and Wu Hou District was better based on live birth than on population.The beds allocation of Gao Xin District,Xin Jin County,Peng Zhou City and Qiong Lai City was poor based on either live birth or population.The beds allocation of the rest was sufficient based on live births.The total utilization rate of beds in Jin Jiang District,Qing Yang District,Wu Hou District,Gao Xin District,Xin Jin County and Chong Zhou City was higher than 93%.The utilization rate of public tertiary beds were higher than 93%except Cheng Hua District,Xin Du District,Da Yi County and Peng Zhou City.The beds utilization rate of public secondary in Qing Yang District and Jin Niu District was lower than 60%.The beds utilization rate of public primary and unknown-rank in all districts and counties was lower than 70%.The utilization rate of beds in private midwifery institutions of Jin Jiang District,Jin Tang County,Jin Niu District and Long Quanyi District was higher than 80%,and the rest was all low.The population-weighted distance of Wuhan,Shenzhen and Chengdu was 6.14km,2.42km and 6.56km separately.The accessibility of central region in Chengdu and Wuhan was the best,the lowest was Qing Yang District(1.6km),Jiang Han District(1.04 km)separately,while the peripheral districts was poor,the highest of which was Qiong Lai City(13.77km)and Huang Pi District(14.97km)separately.Fu Tian District(1.68km)and Luo Hu District(1.57km)had the best accessibility in Shenzhen,while Da Peng New District(5.35km)and Guang Ming New District(4.38km)were in worse condition.There was a positive linear correlation between density of obstetrical beds and population density,GDP per capita,the disposable income of the residents per capita.Conclusion There was sufficient allocation in Wuhan except Hong Shan District,and it was a phenomenon that the utilization rate of beds in central urban areas was too high and the beds in peripheral districts were idle at the same time;the allocation of beds in some old urban areas of Shenzhen was tight,with heavy workload,and the allocation of new areas was relatively loose.The allocation of obstetrical beds in the central regions of Chengdu was relatively tight and there existed heavy workload for public tertiary,secondary,or private midwifery institutions in some peripheral districts.The central regions of Wuhan and Chengdu had better accessibility,and the peripheral districts were not.Shenzhen had better accessibility than another two cities.The population density,the GDP per capita and the disposable income of the residents per capita were the factors affecting the density of the obstetrical beds in Chengdu. |
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