基于改进潜能模型的城市医疗设施空间可达性——以上海市杨浦区为例
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摘要
引入人口规模因子和医疗设施等级规模影响系数改进潜能模型,基于GIS空间分析技术,以上海杨浦区为例对其医疗设施空间可达性进行研究。结果表明:杨浦区医疗设施空间可达性分布不均,大桥街道、定海路街道及殷行街道部分区域医疗设施空间可达性较高;中部区域一些街道存在同等级医院位置密集、医疗资源相对集中的情况;杨浦区三级医院的居民就医空间可达性整体优于二级、一级医院。改进的潜能模型综合考虑了居民点人口数量、医疗设施与居民点之间的出行阻抗、以及医疗设施的等级规模对居民就医选择的影响,能更合理地评价医疗设施的可达性。研究结果可为城市医疗设施科学规划与决策提供依据。
Medical services are the basic requirement of the public and are closely related to public health. The rationality of the layout and spatial accessibility of medical facilities are closely related to the right of the public to healthcare. Spatial accessibility of medical facilities represents the convenience for residents to obtain medical services. Using GIS and an improved potential model that introduces population scale factor and medical facility grade influence coefficient to traditional potential model, the spatial accessibility of urban medical facilities in Yangpu District of Shanghai was studied. By applying a spatial interpolation method, accessibility of medical facilities of Yangpu District in 2016 was obtained. Moreover, hotspot analysis was used for the cluster analysis of spatial accessibility. The results indicate that the spatial accessibility of urban medical facilities in different community of Yangpu District varies. The spatial accessibility in the central area of Yangpu District is higher than that of other areas. Spatial accessibility is relatively high in Daqiao subdistrict, Dinghai Road subdistrict,and some areas of Yinxing subdistrict. Hospitals of the same grade in the subdistricts of the central area are so closely located that medical resources are of high concentration in these areas. Overall, spatial accessibility of tertiary hospitals is better than secondary and primary hospitals in Yangpu. The improved potential model can evaluate the spatial accessibility of urban medical facilities reasonably by integrating population in demands,travel impedance between residential areas and medical facilities, and the influence of medical facility grade on residents' choice of medical services. By using GIS, the difference of spatial accessibility of urban medical facilities can be visualized. Furthermore, areas with insufficient medical resources can be defined. The results can not only enrich public facility spatial planning theory, but also provide references for the decision making of relevant government departments.
Medical services are the basic requirement of the public and are closely related to public health. The rationality of the layout and spatial accessibility of medical facilities are closely related to the right of the public to healthcare. Spatial accessibility of medical facilities represents the convenience for residents to obtain medical services. Using GIS and an improved potential model that introduces population scale factor and medical facility grade influence coefficient to traditional potential model, the spatial accessibility of urban medical facilities in Yangpu District of Shanghai was studied. By applying a spatial interpolation method, accessibility of medical facilities of Yangpu District in 2016 was obtained. Moreover, hotspot analysis was used for the cluster analysis of spatial accessibility. The results indicate that the spatial accessibility of urban medical facilities in different community of Yangpu District varies. The spatial accessibility in the central area of Yangpu District is higher than that of other areas. Spatial accessibility is relatively high in Daqiao subdistrict, Dinghai Road subdistrict,and some areas of Yinxing subdistrict. Hospitals of the same grade in the subdistricts of the central area are so closely located that medical resources are of high concentration in these areas. Overall, spatial accessibility of tertiary hospitals is better than secondary and primary hospitals in Yangpu. The improved potential model can evaluate the spatial accessibility of urban medical facilities reasonably by integrating population in demands,travel impedance between residential areas and medical facilities, and the influence of medical facility grade on residents' choice of medical services. By using GIS, the difference of spatial accessibility of urban medical facilities can be visualized. Furthermore, areas with insufficient medical resources can be defined. The results can not only enrich public facility spatial planning theory, but also provide references for the decision making of relevant government departments.
引文
陈晨,修春亮.2014.基于交通网络中心性的长春市大型综合医院空间可达性研究[J].人文地理,29(5):81-87.[Chen C,Xiu C L.2014.Spatial accessibility of large general hospitals in Changchun City center based on street network centrality[J].Human Geography,29(5):81-87.]
邓丽,邵景安,郭跃,等.2015.基于改进的两步移动搜索法的山区医疗服务空间可达性:以重庆市石柱县为例[J].地理科学进展,34(6):716-725.[Deng L,Shao J A,Guo Y,et al.2015.Spatial accessibility of medical services in mountainous regions based on modified two-step floating catchment area method:A case study of Shizhu County,Chongqing[J].Progress in Geography,34(6):716-725.]
邓羽,蔡建明,杨振山,等.2012.北京城区交通时间可达性测度及其空间特征分析[J].地理学报,67(2):169-178.[Deng Y,Cai J M,Yang Z S,et al.2012.Measuring time accessibility with its spatial characteristics in urban areas of Beijing[J].Acta Geographica Sinica,67(2):169-178.]
丁秋贤,朱丽霞,罗静.2016.武汉市养老设施空间可达性分析[J].人文地理,31(2):36-42.[Ding Q X,Zhu L X,Luo J.2016.Analysing spatial accessibility to residential care facilities in Wuhan[J].Human Geography,31(2):36-42.]
丁愫,陈报章.2017.城市医疗设施空间分布合理性评估[J].地球信息科学学报,19(2):185-196.[Ding S,Chen B Z.2017.Rationality assessment of the spatial distributions of urban medical facility[J].Journal of Geo-information Science,19(2):185-196.]
胡瑞山,董锁成,胡浩.2012.就医空间可达性分析的两步移动搜索法:以江苏省东海县为例[J].地理科学进展,31(12):1600-1607.[Hu R S,Dong S C,Hu H.2012.A Twostep Floating Catchment Area(2SFCA)method for measuring spatial accessibility to primary healthcare service in China:A case study of Donghai County in Jiangsu Province[J].Progress in Geography,31(12):1600-1607.]
孔云峰,李小建,张雪峰.2008.农村中小学布局调整之空间可达性分析:以河南省巩义市初级中学为例[J].遥感学报,12(5):800-809.[Kong Y F,Li X J,Zhang X F.2008.Analysis of spatial accessibility for school redistricting in rural China:A case study of the secondary schools in Gongyi City,Henan Province[J].Journal of Remote Sensing,12(5):800-809.]
林康,陆玉麒,刘俊,等.2009.基于可达性角度的公共产品空间公平性的定量评价方法:以江苏省仪征市为例[J].地理研究,28(1):215-224.[Lin K,Lu Y Q,Liu J,et al.2009.Assessment of fair space of public product based on accessibility:A case of Yizheng City[J].Geographical Research,28(1):215-224.]
孟庆香,刘国彬,杨勤科.2009.黄土高原年均温的空间插值方法研究[J].干旱区资源与环境,23(3):83-87.[Meng QX,Liu G B,Yang Q K.2009.Research on spatial interpolation methods of annual average temperature on Loess Plateau[J].Journal of Arid Land Resources and Environment,23(3):83-87.]
孟田田,张晶.2017.北京城区就医可达性评价及空间特征分析[J].地理空间信息,15(3):62-65.[Meng T T,Zhang J.2017.Evaluation of health care service spatial accessibility and the analysis of the spatial distribution characteristics in Beijing[J].Geospatial Information,15(3):62-65.]
宋正娜,陈雯.2009.基于潜能模型的医疗设施空间可达性评价方法[J].地理科学进展,28(6):848-854.[Song Z N,Chen W.2009.Measuring spatial accessibility to health care facilities based on potential model[J].Progress in Geography,28(6):848-854.]
宋正娜,陈雯,车前进,等.2010.基于改进潜能模型的就医空间可达性度量和缺医地区判断:以江苏省如东县为例[J].地理科学,30(2):213-219.[Song Z N,Chen W,Che QJ,et al.2010.Measurement of spatial accessibility to health care facilities and defining health professional shortage areas based on improved potential model:A case study of Rudong County in Jiangsu Province[J].Scientia Geographica Sinica,30(2):213-219.]
孙瑜康,吕斌,赵勇健.2015.基于出行调查和GIS分析的县域公共服务设施配置评价研究:以德兴市医疗设施为例[J].人文地理,30(3):103-110.[Sun Y K,Lv B,Zhao Y J.2015.A study of county public service facilities distribution assessment based on behavior investigation and GIS:A case study of medical facilities in Dexing[J].Human Geography,30(3):103-110.]
汤鹏飞,向京京,罗静,等.2017.基于改进潜能模型的县域小学空间可达性研究:以湖北省仙桃市为例[J].地理科学进展,36(6):697-708.[Tang P F,Xiang J J,Luo J,et al.2017.Spatial accessibility analysis of primary schools at the county level based on the improved potential model:Acase study of Xiantao City,Hubei Province[J].Progress in Geography,36(6):697-708.]
陶卓霖,程杨,戴特奇.2014.北京市养老设施空间可达性评价[J].地理科学进展,33(5):616-624.[Tao Z L,Cheng Y,Dai T Q.2014.Measuring spatial accessibility to residential care facilities in Beijing[J].Progress in Geography,33(5):616-624.]
陶卓霖,程杨,戴特奇,等.2017.公共服务设施空间可达性评价中的参数敏感性分析[J].现代城市研究,32(3):30-35.[Tao Z L,Cheng Y,Dai T Q,et al.2017.Sensitivity analysis of parameters in measuring spatial accessibility to public service facilities[J].Modern Urban Research,32(3):30-35.]
佟圣楠,陈航航.2017.基于街道尺度的医疗设施可达性评价:以深圳市为例[J].卫生经济研究,(2):31-34.[Tong SN,Chen H H.2017.Evaluation of accessibility of medical facilities based on street scale:A case study in Shenzhen City[J].Health Economics Research,(2):31-34.]
吴建军,孔云峰,李斌.2008.基于GIS的农村医疗设施空间可达性分析:以河南省兰考县为例[J].人文地理,23(5):37-42.[Wu J J,Kong Y F,Li B.2008.The spatial accessibility analysis of rural medical facilities based on GIS:Acase study of Lankao County,Henan Province[J].Human Geography,23(5):37-42.]
熊娟,罗静,彭菁,等.2012.基于可达性的县域医疗服务均等化分析:以湖北省松滋市为例[J].人文地理,27(5):25-29,119.[Xiong J,Luo J,Peng J,et al.2012.Equalization analysis of medical service of county level based on accessibility:A case study of Songzi,Hubei Province[J].Human Geography,27(5):25-29,119.]
易湘生,李国胜,尹衍雨,等.2012.土壤厚度的空间插值方法比较:以青海三江源地区为例[J].地理研究,31(10):1793-1805.[Yi X S,Li G S,Yin Y Y,et al.2012.Comparison on soil depth prediction among different spatial interpolation methods:A case study in the Three-River Headwaters Region of Qinghai Province[J].Geographical Research,31(10):1793-1805.]
曾文,向梨丽,张小林.2017.南京市社区服务设施可达性的空间格局与低收入社区空间剥夺研究[J].人文地理,32(1):73-81.[Zeng W,Xiang L L,Zhang X L.2017.Research in spatial pattern of accessibility to community service facilities and spatial deprivation of low income community in Nanjing[J].Human Geography,32(1):73-81.]
钟少颖,杨鑫,陈锐.2016.层级性公共服务设施空间可达性研究:以北京市综合性医疗设施为例[J].地理研究,35(4):731-744.[Zhong S Y,Yang X,Chen R.2016.The accessibility measurement of hierarchy public service facilities based on multi-mode network dataset and the two-step2SFCA:A case study of Beijing's medical facilities[J].Geographical Research,35(4):731-744.]
Cheng G,Zeng X K,Duan L,et al.2016.Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen,China[J].Habitat International,53:485-494.
Fan P L,Xu L H,Yue W Z,et al.2017.Accessibility of public urban green space in an urban periphery:The case of Shanghai[J].Landscape and Urban Planning,165:177-192.
Gharani P,Stewart K,Ryan G L.2015.An enhanced approach for modeling spatial accessibility for in vitro fertilization services in the rural Midwestern United States[J].Applied Geography,64:12-23.
Kalogirou S,Foley R.2006.Health,place and Hanly:Modelling accessibility to hospitals in Ireland[J].Irish Geography,39(1):52-68.
Ortega E,López E,Monzón A.2012.Territorial cohesion impacts of high-speed rail at different planning levels[J].Journal of Transport Geography,24:130-141.
Pan J,Zhao H Q,Wang X L,et al.2016.Assessing spatial access to public and private hospitals in Sichuan,China:The influence of the private sector on the healthcare geography in China[J].Social Science&Medicine,170:35-45.
Peeters D,Thomas I.2000.Distance predicting functions and applied location-allocation models[J].Journal of Geographical Systems,2(2):167-184.
Porta S,Latora V,Wang F H,et al.2012.Street centrality and the location of economic activities in Barcelona[J].Urban Studies,49(7):1471-1488.
Reggiani A,Bucci P,Russo G.2011.Accessibility and impedance forms:Empirical applications to the German commuting networks[J].International Regional Science Review,34(2):230-252.
Siegel M,Koller D,Vogt V,et al.2016.Developing a composite index of spatial accessibility across different health care sectors:A German example[J].Health Policy,120(2):205-212.
Suárez P,Mayor M,Cueto B.2012.The accessibility to employment offices in the Spanish labour market[J].Papers in Regional Science,91(4):823-848.
Weibull.J W.1976.An axiomatic approach to the measurement of accessibility[J].Regional Science and Urban Economics,6(4):357-379.
Wu C,Ye X Y,Du Q Y,et al.2017.Spatial effects of accessibility to parks on housing prices in Shenzhen,China[J].Habitat International,63:45-54.
Yang N,Chen S Y,Hu W L,et al.2016.Spatial distribution balance analysis of hospitals in Wuhan[J].International Journal of Environmental Research and Public Health,13(10):971.
邓丽,邵景安,郭跃,等.2015.基于改进的两步移动搜索法的山区医疗服务空间可达性:以重庆市石柱县为例[J].地理科学进展,34(6):716-725.[Deng L,Shao J A,Guo Y,et al.2015.Spatial accessibility of medical services in mountainous regions based on modified two-step floating catchment area method:A case study of Shizhu County,Chongqing[J].Progress in Geography,34(6):716-725.]
邓羽,蔡建明,杨振山,等.2012.北京城区交通时间可达性测度及其空间特征分析[J].地理学报,67(2):169-178.[Deng Y,Cai J M,Yang Z S,et al.2012.Measuring time accessibility with its spatial characteristics in urban areas of Beijing[J].Acta Geographica Sinica,67(2):169-178.]
丁秋贤,朱丽霞,罗静.2016.武汉市养老设施空间可达性分析[J].人文地理,31(2):36-42.[Ding Q X,Zhu L X,Luo J.2016.Analysing spatial accessibility to residential care facilities in Wuhan[J].Human Geography,31(2):36-42.]
丁愫,陈报章.2017.城市医疗设施空间分布合理性评估[J].地球信息科学学报,19(2):185-196.[Ding S,Chen B Z.2017.Rationality assessment of the spatial distributions of urban medical facility[J].Journal of Geo-information Science,19(2):185-196.]
胡瑞山,董锁成,胡浩.2012.就医空间可达性分析的两步移动搜索法:以江苏省东海县为例[J].地理科学进展,31(12):1600-1607.[Hu R S,Dong S C,Hu H.2012.A Twostep Floating Catchment Area(2SFCA)method for measuring spatial accessibility to primary healthcare service in China:A case study of Donghai County in Jiangsu Province[J].Progress in Geography,31(12):1600-1607.]
孔云峰,李小建,张雪峰.2008.农村中小学布局调整之空间可达性分析:以河南省巩义市初级中学为例[J].遥感学报,12(5):800-809.[Kong Y F,Li X J,Zhang X F.2008.Analysis of spatial accessibility for school redistricting in rural China:A case study of the secondary schools in Gongyi City,Henan Province[J].Journal of Remote Sensing,12(5):800-809.]
林康,陆玉麒,刘俊,等.2009.基于可达性角度的公共产品空间公平性的定量评价方法:以江苏省仪征市为例[J].地理研究,28(1):215-224.[Lin K,Lu Y Q,Liu J,et al.2009.Assessment of fair space of public product based on accessibility:A case of Yizheng City[J].Geographical Research,28(1):215-224.]
孟庆香,刘国彬,杨勤科.2009.黄土高原年均温的空间插值方法研究[J].干旱区资源与环境,23(3):83-87.[Meng QX,Liu G B,Yang Q K.2009.Research on spatial interpolation methods of annual average temperature on Loess Plateau[J].Journal of Arid Land Resources and Environment,23(3):83-87.]
孟田田,张晶.2017.北京城区就医可达性评价及空间特征分析[J].地理空间信息,15(3):62-65.[Meng T T,Zhang J.2017.Evaluation of health care service spatial accessibility and the analysis of the spatial distribution characteristics in Beijing[J].Geospatial Information,15(3):62-65.]
宋正娜,陈雯.2009.基于潜能模型的医疗设施空间可达性评价方法[J].地理科学进展,28(6):848-854.[Song Z N,Chen W.2009.Measuring spatial accessibility to health care facilities based on potential model[J].Progress in Geography,28(6):848-854.]
宋正娜,陈雯,车前进,等.2010.基于改进潜能模型的就医空间可达性度量和缺医地区判断:以江苏省如东县为例[J].地理科学,30(2):213-219.[Song Z N,Chen W,Che QJ,et al.2010.Measurement of spatial accessibility to health care facilities and defining health professional shortage areas based on improved potential model:A case study of Rudong County in Jiangsu Province[J].Scientia Geographica Sinica,30(2):213-219.]
孙瑜康,吕斌,赵勇健.2015.基于出行调查和GIS分析的县域公共服务设施配置评价研究:以德兴市医疗设施为例[J].人文地理,30(3):103-110.[Sun Y K,Lv B,Zhao Y J.2015.A study of county public service facilities distribution assessment based on behavior investigation and GIS:A case study of medical facilities in Dexing[J].Human Geography,30(3):103-110.]
汤鹏飞,向京京,罗静,等.2017.基于改进潜能模型的县域小学空间可达性研究:以湖北省仙桃市为例[J].地理科学进展,36(6):697-708.[Tang P F,Xiang J J,Luo J,et al.2017.Spatial accessibility analysis of primary schools at the county level based on the improved potential model:Acase study of Xiantao City,Hubei Province[J].Progress in Geography,36(6):697-708.]
陶卓霖,程杨,戴特奇.2014.北京市养老设施空间可达性评价[J].地理科学进展,33(5):616-624.[Tao Z L,Cheng Y,Dai T Q.2014.Measuring spatial accessibility to residential care facilities in Beijing[J].Progress in Geography,33(5):616-624.]
陶卓霖,程杨,戴特奇,等.2017.公共服务设施空间可达性评价中的参数敏感性分析[J].现代城市研究,32(3):30-35.[Tao Z L,Cheng Y,Dai T Q,et al.2017.Sensitivity analysis of parameters in measuring spatial accessibility to public service facilities[J].Modern Urban Research,32(3):30-35.]
佟圣楠,陈航航.2017.基于街道尺度的医疗设施可达性评价:以深圳市为例[J].卫生经济研究,(2):31-34.[Tong SN,Chen H H.2017.Evaluation of accessibility of medical facilities based on street scale:A case study in Shenzhen City[J].Health Economics Research,(2):31-34.]
吴建军,孔云峰,李斌.2008.基于GIS的农村医疗设施空间可达性分析:以河南省兰考县为例[J].人文地理,23(5):37-42.[Wu J J,Kong Y F,Li B.2008.The spatial accessibility analysis of rural medical facilities based on GIS:Acase study of Lankao County,Henan Province[J].Human Geography,23(5):37-42.]
熊娟,罗静,彭菁,等.2012.基于可达性的县域医疗服务均等化分析:以湖北省松滋市为例[J].人文地理,27(5):25-29,119.[Xiong J,Luo J,Peng J,et al.2012.Equalization analysis of medical service of county level based on accessibility:A case study of Songzi,Hubei Province[J].Human Geography,27(5):25-29,119.]
易湘生,李国胜,尹衍雨,等.2012.土壤厚度的空间插值方法比较:以青海三江源地区为例[J].地理研究,31(10):1793-1805.[Yi X S,Li G S,Yin Y Y,et al.2012.Comparison on soil depth prediction among different spatial interpolation methods:A case study in the Three-River Headwaters Region of Qinghai Province[J].Geographical Research,31(10):1793-1805.]
曾文,向梨丽,张小林.2017.南京市社区服务设施可达性的空间格局与低收入社区空间剥夺研究[J].人文地理,32(1):73-81.[Zeng W,Xiang L L,Zhang X L.2017.Research in spatial pattern of accessibility to community service facilities and spatial deprivation of low income community in Nanjing[J].Human Geography,32(1):73-81.]
钟少颖,杨鑫,陈锐.2016.层级性公共服务设施空间可达性研究:以北京市综合性医疗设施为例[J].地理研究,35(4):731-744.[Zhong S Y,Yang X,Chen R.2016.The accessibility measurement of hierarchy public service facilities based on multi-mode network dataset and the two-step2SFCA:A case study of Beijing's medical facilities[J].Geographical Research,35(4):731-744.]
Cheng G,Zeng X K,Duan L,et al.2016.Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen,China[J].Habitat International,53:485-494.
Fan P L,Xu L H,Yue W Z,et al.2017.Accessibility of public urban green space in an urban periphery:The case of Shanghai[J].Landscape and Urban Planning,165:177-192.
Gharani P,Stewart K,Ryan G L.2015.An enhanced approach for modeling spatial accessibility for in vitro fertilization services in the rural Midwestern United States[J].Applied Geography,64:12-23.
Kalogirou S,Foley R.2006.Health,place and Hanly:Modelling accessibility to hospitals in Ireland[J].Irish Geography,39(1):52-68.
Ortega E,López E,Monzón A.2012.Territorial cohesion impacts of high-speed rail at different planning levels[J].Journal of Transport Geography,24:130-141.
Pan J,Zhao H Q,Wang X L,et al.2016.Assessing spatial access to public and private hospitals in Sichuan,China:The influence of the private sector on the healthcare geography in China[J].Social Science&Medicine,170:35-45.
Peeters D,Thomas I.2000.Distance predicting functions and applied location-allocation models[J].Journal of Geographical Systems,2(2):167-184.
Porta S,Latora V,Wang F H,et al.2012.Street centrality and the location of economic activities in Barcelona[J].Urban Studies,49(7):1471-1488.
Reggiani A,Bucci P,Russo G.2011.Accessibility and impedance forms:Empirical applications to the German commuting networks[J].International Regional Science Review,34(2):230-252.
Siegel M,Koller D,Vogt V,et al.2016.Developing a composite index of spatial accessibility across different health care sectors:A German example[J].Health Policy,120(2):205-212.
Suárez P,Mayor M,Cueto B.2012.The accessibility to employment offices in the Spanish labour market[J].Papers in Regional Science,91(4):823-848.
Weibull.J W.1976.An axiomatic approach to the measurement of accessibility[J].Regional Science and Urban Economics,6(4):357-379.
Wu C,Ye X Y,Du Q Y,et al.2017.Spatial effects of accessibility to parks on housing prices in Shenzhen,China[J].Habitat International,63:45-54.
Yang N,Chen S Y,Hu W L,et al.2016.Spatial distribution balance analysis of hospitals in Wuhan[J].International Journal of Environmental Research and Public Health,13(10):971.