基于分级诊疗的就医可达性研究——以潍坊市中心城区为例

基于GIS技术, 利用改进的两步移动搜索法, 研究潍坊市中心城区的就医可达性。考虑分级诊疗对居民就医可达性的影响, 以社区为基本单元, 分析中心城区的医疗资源分布特征。结果表明, 潍坊市中心城区就医可达性呈多中心分布, 中部社区、东北部社区和东部部分社区可达性水平较高, 中心城区边缘社区可达性水平较低; 在不同转诊率水平下, 分级诊疗均能提升社区居民的就医可达性水平; 由于二、三级医院分布集中于中部和东北部, 分级诊疗也会加剧各社区之间就医可达性的差异, 且难以兼顾服务的公平性。根据研究结果, 建议优化医疗设施布局, 将医疗资源向中心城区边缘地区引导, 着重在社区中心位置布局基层医疗设施, 提升居民就医的便利程度。

Research on Accessibility of Medical Treatment Based on Grading Treatment: A Case Study of Weifang City Center Area

Based on GIS technology, the improved two step floating catchment area method is applied to study the accessibility of medical treatment in the Weifang city center area and assess the impact of graded diagnosis and treatment on the accessibility of residents with the community as the basic unit. The conclusion is that the accessibility of medical treatment in the downtown area of Weifang is multi-centered, and the accessibility of communities distributed in center, northeast and east part of the city is relatively high, and those at the edge of the central urban area is low. The medical accessibility is improved under graded diagnosis with different referral rates, However, because the second and third-level hospitals are concentrated in the central and northeastern regions, graded diagnosis and treatment will also aggravate the differences in accessibility between communities, which makes it difficult to maintain fairness. Therefore the layout of medical facilities should be improved by guiding medical resources to the fringe areas of the central city, and locating primary medical facilities in the center of the community to improve the convenience of residents.