Spatial Differences And Causes Of Medical Service Accessibility In Gansu Province

While the development of China's medical and health undertakings has achieved remarkable results,the medical and health construction has put forward higher requirements due to the transformation of people's lifestyle,the intensification of population aging and the diversification of residents' health needs.At the same time,the unbalanced and insufficient development of medical services is still prominent under the new situation and challenges,which has attracted extensive attention from the government and academia.This imbalance and inadequacy is more prominent in the economically underdeveloped western region,which can be reflected in the weaknesses of medical services,the overall shortage of high-quality resources,the large differences between regions and urban and rural areas,and the low degree of fairness.Therefore,identifying the problem of medical shortage,one of the issues closely concerned in the current medical and health field,can help to accelerate the improvement of medical service quality and efficiency and promote regional coordinated development.Accessibility evaluation plays an important role in revealing spatial differences and regional equity.It is an effective tool to evaluate the rationality of resource allocation and widely used in medical service research.In the above context,my research builds a medical service accessibility database based on the relevant data of population density,traffic network and medical facilities in Gansu Province,and calculates the medical service accessibility in Gansu Province based on the two-step floating catchment area method,combined with multi-level radius and Gaussian distance attenuation function.Then,the spatial differentiation characteristics of medical service accessibility are analyzed from three perspectives: multi-dimensional scale,multi-level medical treatment and different medical circles.Meanwhile,the distribution difference and spatial agglomeration characteristics of medical service accessibility are evaluated based on Gini coefficient and spatial autocorrelation index,respectively.Further,the partial correlation analysis method is used to explore the impact of population,transportation and medical facilities on the accessibility of medical services,based on the above analysis so as to explain the formation mechanism of spatial differences.Finally,Suggestions on the optimization of medical resources are put forward,which are expected to provide scientific reference for the overall planning and layout of medical services in Gansu Province.The conclusions are as follows:(1)There are significant spatial differences in the accessibility of medical services in Gansu Province,showing a pattern of high in the southeast and low in the northwest at the provincial scale,with about 52% of residents obtaining better medical service resources,and a pattern of decrease from the central urban area to the periphery in the internal scale of each city area,with different equilibrium degree and Jinchang City and Jiayuguan City being the better ones.The higher the level of medical institutions,the greater the spatial difference in accessibility;the smaller the time radius of the medical circle,the more obvious the spatial differentiation state of accessibility.And nearly 90% of people can meet the medical needs within 30 minutes.(2)The agglomeration degree of medical service accessibility in Gansu Province is relatively high,and the overall spatial distribution is unfair,with an obvious spatial deprivation effect.Accessibility is more equitable by population distribution than by geographic area,with the best accessibility to primary care services;And the accessibility shows an obvious positive correlation in space,which reflects the spatial inequality of medical service capacity in Gansu Province.(3)The location distribution of medical demand points,medical supply parties and the connection relationship between the two are the key factors affecting the accessibility of medical services in Gansu Province,and the volume,leading factors and matching of each element jointly affect the accessibility of medical services.In general,the contribution of medical resources to accessibility is relatively high,and the matching between the elements has obvious spatial differences,forming a gradient of "city-county-township",with a significant positive correlation with the economic level of the region.The formation mechanism of spatial accessibility characteristics of medical services in different regions is different,and comprehensive analysis can divide Gansu Province into three types according to the municipal scale,namely resource-oriented,transportation-oriented and matching effectiveness.