通讯作者: 唐艳, xytangyan@csu.edu.cn

DOI：10.12201/bmr.202107.00022

Spatial Accessibility Analysis of Fever Clinics and Designated Hospitals in Response to Epidemic Events of Infectious Diseases: A Case Study of Hunan Province

• 摘要：目的 描述分析发热门诊和定点救治医院的空间分布与可达性，为应对重大传染病流行事件的医疗资源供给配置提供参考依据。方法 以湖南省为研究区域，以344家发热门诊和224家定点救治医院（含后备医院）为研究对象，采用最近设施点分析和两步移动搜索法分别分析发热门诊和定点救治医院的可达性。 结果 湖南省发热门诊每10万人0.51个、每千平方公里1.62个，70.35%（242家）设置在二级医疗机构，45.25%的居民和16.31%的地域能在15分钟内行车到达发热门诊；发热门诊多位于人口较为集中的区域，呈现以县中心可达性高且向边缘递减的空间格局。湖南省定点救治医院的床位总数为14.35万张，每万人床位数为21.19张，55.74%（136家）设置在二级医疗机构；在0.61h和1.22h成本阻抗下可达性均值分别为3.56±4.83和3.91±3.17，呈现西部可达性较高、人口高密度地区相对较低的空间格局。 结论 湖南省发热门诊在市县之间空间分布较为均衡，人口密度较高的城市配置较多，有利于城市早期发现病例，但行车60分钟才能基本覆盖全域和绝大部分居民，一定程度上影响“哨点”作用的发挥。湖南省定点救治医院的床位资源配置较足，但是人口密度高的城市地区可达性较低，定点救治医院主要设置在区县中心区域，区县农村地区在成本阻抗0.61h下医院服务范围不能到达，呈现可达性较低的情况。建议结合湖南省基层医疗机构的资源进一步优化农村地区发热门诊以及城市定点救治医院的布局配置。

  关键词： 传染病流行事件；发热门诊；定点救治医院；可达性

   

  Abstract: Objective To analyze the spatial distribution and accessibility of fever clinics and designated hospitals, so as to provide reference for the allocation of medical resources in response to major infectious disease epidemic events. Methods Taking Hunan Province as the research area, 344 fever clinics and 224 designated hospitals (including backup hospitals) were selected as the research objects. The nearest facility analysis and two-step floating catchment area method were used to analyze the accessibility of fever clinics and designated hospitals. Results There were 0.51 fever clinics per 100,000 people and 1.62 fever clinics per thousand square kilometers in Hunan province. 70.35% (242) were located in secondary medical institutions. 45.25% of residents and 16.31% of areas could reach fever clinics within 15 minutes by car. Fever clinics are mostly located in densely populated areas, showing a spatial pattern of high accessibility to the center of the county and decreasing to the edge. The total number of beds in designated hospitals in Hunan province is 143,500, with 21.19 beds per 10,000 people, and 55.74% (136) of these hospitals are secondary medical institutions. At 0.61h and 1.22h cost impedance, the mean values of accessibility were 3.56±4.83 and 3.91±3.17, respectively, showing a spatial pattern of higher accessibility in the western region and lower accessibility in the high-density region. Conclusion The spatial distribution of fever clinics in Hunan province is relatively balanced among cities and counties. The allocation of cities with higher population density is more, which is conducive to the early detection of cases in cities. However, the basic coverage of the whole region and the majority of residents need to drive for 60 minutes, which affects the function of the sentinel. In Hunan province, the allocation of beds in designated treatment hospitals is sufficient, but the accessibility in urban areas with high population density is low. The designated treatment hospitals are mainly located in the central areas of districts and counties, and the service scope of hospitals in rural areas of districts and counties cannot be reached under the cost impedance of 0.61h, showing a low accessibility. It is suggested to further optimize the layout and configuration of fever clinics in marginal rural areas and designated hospitals in cities by combining with the resources of primary medical institutions in Hunan Province.

  Key words: Epidemic events of infectious diseases；fever clinic； designated hospital； accessibility

  提交时间：2021-10-08

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• 序号	提交日期	编号	操作
  1	2021-07-19	bmr.202107.00022V1	下载

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