Evaluation And Layout Optimization Of Hierarchical Diagnosis And Treatment Configuration Of Medical Facilities In Large Cities Based On Epidemic Prevention

Medical facilities are an important part of urban public service facilities.The site selection,layout,scale and facility function of medical facilities in China are mainly constructed based on the population size in a certain region and the daily medical treatment.With the rapid expansion of the city scale and the increase of the gap of residents’ income level,the contradiction of medical treatment is becoming more and more complicated.The hierarchical diagnosis and treatment system in China is put forward to ensure the efficient and reasonable use of medical facilities at all levels and relieve the pressure of high quality medical resources.Under the influence of various social factors,the system was promoted slowly in daily medical treatment.However,after the outbreak of public health events in2020,the hierarchical diagnosis and treatment model in Wuhan was rapidly established and strictly implemented in a short period of time under the emergency state,which greatly improved the efficiency of patient screening and treatment.To effectively promote the grading system implementation,strengthen the ability of resistance to public health emergencies of big cities,combining with the characteristics of the grading system analysis different levels of medical facilities service scope and service capabilities,combined with the medical needs of normal population and epidemic disease spread risk evaluate the spatial distribution characteristics of medical facilities spatial configuration,for flat disease combined with medical facilities space configuration optimization direction.Taking Wuhan City as an example,this paper firstly divides the medical demand into two types according to the total population(daily medical treatment)and epidemic transmission(epidemic period),and divides the medical facility supply into three levels according to municipal hospital,district hospital and community hospital.Secondly,combining the spatial distribution of medical demand in peacetime and epidemic time with the supply intensity of medical facilities at all levels,the spatial matching was carried out to analyze the supply-demand characteristics of medical resources.Finally,based on the results of supply and demand analysis of the two types of medical services,the optimization goal of the hierarchical diagnosis and treatment system combining epidemic prevention is proposed,and preliminary technical indicators are suggested for the service population,bed size,service scope and site selection of medical facilities that meet the functions of daily medical treatment and epidemic prevention.The results show that :(1)The daily medical demand in Wuhan is concentrated in the central urban area,and the elderly population has a large demand for medical treatment;The risk of epidemic transmission in urban areas was higher than that in suburban areas,and the highest in remote urban areas.(2)The total amount of medical resources in Wuhan is rich,but the spatial distribution of municipal and district-level hospitals is too concentrated,and the overall construction of community-level medical facilities is insufficient.(3)There are significant differences in the supply and demand relationship between different administrative areas,streets and community management units.The supply of high-quality resources in central urban areas is too high while the supply in distant urban areas and rural areas is insufficient.(4)The current medical facility layout is not highly matched with the results of the risk assessment of urban epidemic transmission,which is mainly manifested in the high risk of epidemic transmission in the remote urban areas but the lack of medical construction at the municipal and community levels.This paper further proposes :(1)Combine the total population within the service scope and the risk of epidemic transmission,and carry out epidemic prevention transformation at all levels of medical facilities;(2)To appropriately evacuate the distribution pattern of municipal hospitals,establish a linkage network between district hospitals and community medical services,and strengthen the precise allocation of community medical facilities,so as to promote the in-depth implementation of the hierarchical diagnosis and treatment system and improve the ability to respond to urban public health emergencies..