基于探索性空间数据分析的西藏县域尺度床位资源时空分布和公平性研究  

Spatial and temporal distribution and equity of county-level bed resources in Tibet based on exploratory spatial data analysis

作　　者：王子钒 孙成彬 罗仕伟[1] 罗勇军 WANG Zi-fan;SUN Cheng-bin;LUO Shi-wei;LUO Yong-jun(College of Geography and Tourism,Chongqing Normal University,Chongqing 401331,China;不详)

机构地区：[1]重庆师范大学地理与旅游学院,重庆401331 [2]陆军军医大学陆军卫勤训练基地军事医学地理学教研室

出　　处：《现代预防医学》2023年第1期127-133,共7页Modern Preventive Medicine

基　　金：国家科技部第二次青藏高原综合科学考察研究专题(2019QZKK0607);2021年度军队卫勤保障能力创新与生成专项计划(21QQ001)。

摘　　要：目的本文对2017—2019年西藏县域尺度下床位资源时空分布动态演变和区域资源配置公平性展开研究,旨在为今后西藏地区床位配置和市-县双尺度医疗资源整合规划提供参考依据。方法以全区74个区县和7个市作为研究对象,利用探索性空间数据分析、基尼系数和集中指数来分析全区床位配置的公平程度。结果研究期间全区床位资源得到了大量补充,床位资源空间分布整体较为随机,但局部地区集中趋势明显,L~L聚集区随时间推移逐渐稳定;市-县双尺度下按人口与经济配置的基尼系数均优于地理面积,县域尺度下按人口、地理面积和经济配置的基尼系数分别为0.453~0.476、0.707~0.744、0.359~0.434与市域尺度存在明显差距;GDP与一般公共预算支出的集中指数均大于0.2,床位资源分布受宏观经济因素影响强烈。结论自治区层面床位资源总量有所提高,空间公平性逐渐改善,空间分布呈去中心化趋势,但中心局部地区点核发展模式依旧明显;市-县之间基尼系数存在明显差距,县域尺度下的床位资源配置急需优化;床位配给受地区宏观经济影响显著且存在供需失衡的风险。此外对地广人稀的研究区域而言,使用基尼系数进行公平性评价时应以区内人口作为配置重点,注重资源配置的均衡性。Objective To study the dynamic evolution of the temporal and spatial distribution of bed resources and the fairness of regional resource allocation at the county scale in Tibet from 2017 to 2019,and to provide a reference for future bed allocation and city-county dual-scale medical resource integration planning in Tibet.Methods 74 districts and 7 cities in the whole district were taken as research objects,exploratory spatial data analysis,Gini coefficient and concentration index were used to analyze the fairness of bed allocation in the whole district.Results During the study period,a large number of bed resources were supplemented in the whole area,and the overall spatial distribution of bed resources was relatively random,but the local concentration trend was obvious,and the L-L cluster area gradually stabilized over time.Gini coefficients allocated by population and economy at the city-county scale were all better than those allocated by geographical area.The Gini coefficients allocated by population,geographical area and economy at the county scale were 0.453-0.476,0.707-0.744 and 0.359-0.434,and there was a clear gap between the county scale and the city scale.The concentration indexes of GDP and general public budget expenditures were both greater than 0.2,and the distribution of bed resources was strongly affected by macroeconomic factors.Conclusion The total amount of bed resources at the autonomous region level has increased,the spatial equity has gradually improved,and the spatial distribution has shown a decentralization trend,but the development pattern of point core in the central and local areas is still obvious.There is a significant gap of Gini coefficient between city and county scale,and the allocation of bed resources at the county scale under current situation needs to be optimized urgently.The allocation of beds is significantly affected by regional macro economy and there is a risk of imbalance of supply and demand.In addition,for the study areas with vast area and sparse population,the popu

关 键 词：床位资源 空间 公平性 宏观经济 地区 

分 类 号：R197.32[医药卫生—卫生事业管理]