中国医疗卫生服务水平的空间分布特征及影响因素

医疗卫生服务是公共服务的重要组成部分，也是建设健康中国的着力点.因此，医疗卫生服务水平的空间分布特征是健康地理学关注的重要问题.建立合理的指标体系，运用因子分析、标准差椭圆法以及空间计量分析模型计算了2004年、2009年以及2014年中国大陆各省份医疗服务水平并分析其空间分布特征和影响因素.结果表明：1)公立医院和民营医院的医疗卫生服务水平均呈现明显的东南－西北分化特征；2)医疗卫生服务水平的高值区为长三角地区、珠三角地区等经济发达地区和四川、河南等人口众多的省份，水平较低的地区分布在内蒙古自治区、青海省和西藏自治区等西部地区.3)空间计量回归模型结果发现，居民消费水平、一级医院数量、抚养比是影响公立医院医疗卫生服务水平的重要因素；居民消费水平、二级医院数量、抚养比和传染病的发病率对于民营医院影响显著.该研究对医疗卫生服务区域均衡政策的制定具有现实意义.

Spatial distribution characteristics and influencing factors of health services in China

Health care services are an important part of public services and a focal point for building healthy China. Therefore， the spatial distribution of health services is an important issue of health geography. By establishing a reasonable index system， the annual medical service levels， spatial distribution， and influencing factors in 2004， 2009， and 2014 in mainland China were calculated using factor analysis， standard deviation ellipse， and spatial econometric model. The results showed that 1) the level of health care services in public hospitals and private hospitals showed obvious characteristics of southeast-northwest differentiation； 2) high-value areas for medical and health services were in economically developed areas such as the Yangtze River Delta and Pearl River Delta， and Sichuan ， Henan and other populous provinces， the lower level areas are located in the western regions such as Inner Mongolia Autonomous Region， Qinghai Province and Tibet Autonomous Region. 3) spatial econometric regression model found that the level of residents' consumption， the number of first-class hospitals and the dependency ratio are the important factors that affect the public health services. Public consumption， the number of secondary hospitals， dependency ratio and the incidence of infectious diseases significantly impact on private hospitals. This study is of great significance to the formulation of balanced policies in the area of health care services and to the regional sustainable development of health care services.