基于地理探测器的欠发达地区健康资源时空分异及影响因素研究  

Spatial-temporal evolution and influencing factors of health resources in underdeveloped areas based on geodetectors

作　　者：赵海莉[1] 王启雯 朱立祥 李晓芹 田浩宇 ZHAO Haili;WANG Qiwen;ZHU Lixiang;LI Xiaoqin;TIAN Haoyu(College of Geography and Environment Science,Northwest Normal University,Lanzhou 730070,Gansu,China)

机构地区：[1]西北师范大学地理与环境科学学院,甘肃兰州730070

出　　处：《干旱区地理》2021年第2期594-603,共10页Arid Land Geography

基　　金：国家自然科学基金项目(42061034)资助。

摘　　要：医疗卫生资源是健康服务体系的基础和保障,高水平、高均衡性的医疗卫生资源是人民健康的保障。以甘肃省为例,基于卫生资源集聚度和变异系数、基尼系数、泰尔指数及分解,分析2010—2017年甘肃省14个市、州医疗卫生资源水平及均衡性的差异,运用地理探测器模型分析影响因素。结果表明:(1)2010—2017年甘肃省医疗卫生资源水平及其均衡性整体上升。(2)医疗卫生资源水平及均衡性分布呈现东南>西北的格局,经济较好的陇中、陇东地区优于其他地区,其中兰州市资源水平及均衡性最高。(3)甘肃省人均医疗卫生资源水平及均衡性要优于地均医疗卫生资源,河西地区由于面积广阔、人口集聚度相对较小,人均均衡性明显优于地均均衡性。(4)甘肃省整体医疗卫生资源水平差异逐渐减小,医疗卫生资源均衡性得到了较好的改善,同时其区域内差异减小、区域间差异逐渐增大,且河西地区和陇中地区的内部差异是甘肃省整体差异的主要贡献者。(5)经济水平是影响医疗卫生资源水平的主导因素,人均国内生产总值和人口老龄化与其他因子的交互作用的解释力较高,同时自然因素的解释力逐年上升。Medical resources are the foundation of a quality health service system which in turn ensures a safe and secure community,therefore,it is important to study regional differences in medical resources and identify the factors that influence them to optimize the planning and distribution of these resources for strategic deployment of the Healthy China Action Plan.Using Gansu Province,China as an example,the coefficient of variation,the Gini coefficient,the Theil index,and the form of decomposition as well as the agglomeration degree of health resources and spatiotemporal differences in the level and equilibrium of medical resources were analyzed for Gansu from 2010 to 2017.The factors affecting the spatial distribution of medical resources were identified using GeoDetector.The results reveal five important facts:(1)From 2010 to 2017,the level and equilibrium of medical resources in Gansu Province increased by 14.96%,which laid the foundation for equal access to basic public services,thereby improving the public service system.The growth rates of medical resources in Hexi,Longzhong,Longdong,and Longnan areas were 24.60%,11.51%,14.91%,and 12.28%,respectively,of which the Hexi area showed the most significant growth.(2)The level and equilibrium of allocation of medical resources presented a pattern of southeast superior to northwest.The level and equilibrium of medical resources in Longdong and Longzhong,which are areas of high economic status,were higher than the levels and equilibria in other areas,among which Lanzhou,Pingliang,and Longnan had relatively high equilibrium.(3)The level and equilibrium of medical resources per capita were better than those for individual geographic locales within Gansu Province,especially in the Hexi area because of its vast area and relatively small population which creates a per capita balance that is better than the average balance for the entire province.(4)The overall difference gradually decreased in Gansu Province over time,and consequently the balance of medical resources improv

关 键 词：医疗卫生资源水平 均衡性 区域差异 地理探测器 

分 类 号：R197.1[医药卫生—卫生事业管理]