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浙江大学学报(理学版)  2024, Vol. 51 Issue (1): 76-89    DOI: 10.3785/j.issn.1008-9497.2024.01.009
地球科学     
长三角地区医疗卫生资源供给的时空演化特征及其影响因素
陈玉娟1(),王志斌1,周启俊1,瞿建平1,陈加正2
1.浙江工业大学 设计与建筑学院,浙江 杭州 310014
2.浙江工业大学工程设计集团有限公司,浙江 杭州 310014
Study on the spatio-temporal evolution characteristics and influencing factors of medical resource supply in the Yangtze River Delta region
Yujuan CHEN1(),Zhibin WANG1,Qijun ZHOU1,Jianping QU1,Jiazheng CHEN2
1.School of Design and Architecture,Zhejiang University of Technology,Hangzhou 310014,China
2.Zhejiang University of Technology Engineering Design Group Co. ,Ltd. ,Hangzhou 310014,China
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摘要:

在健康中国与长三角区域一体化发展国家战略的目标驱使下,医疗卫生资源供给能力日渐成为区域公共设施均等化发展的重要指标,新型冠状病毒肺炎疫情等突发公共卫生事件对地区医疗卫生资源供给能力提出了更高的要求。为辨明长三角地区医疗卫生资源供给的发展特征与影响因素,构建了以时间演变、空间分异与因子探究为主的分析结构,采用泰尔指数、空间自相关、多尺度地理加权回归等方法,研究了2001—2019年长三角地区41个城市医疗卫生资源供给的区域差异与影响因素。结果表明,研究期内长三角地区医疗卫生资源增长迅速,区域均衡性提高;总体格局与长三角“Z”字形空间结构相吻合;医疗卫生资源供给的影响因素涵盖社会、经济与政治3个维度,且作用强度存在空间异质性。在此基础上,提出了促进长三角地区医疗服务一体化发展的对策及建议。

关键词: 医疗卫生资源区域差异多尺度地理加权回归长三角地区    
Abstract:

Driven by the national strategies of health China and the integrated development of the Yangtze River Delta region, the supply capacity of health care resources has become an important indicator of the equalization of regional public facilities, and public health emergencies such as the new coronavirus pneumonia epidemic have put forward higher requirements on the supply capacity of regional health care resources. In order to identify the development characteristics and influencing factors of health care resource supply capacity in Yangtze River Delta, this article constructs an analytical structure with temporal evolution, spatial differentiation and factor exploration, and adopts the methods of Thiel index, spatial autocorrelation and multi-scale geographically weighted regression to study the regional differences and influencing factors of healthcare resource supply capacity in 41 prefecture-level cities in Yangtze River Delta from 2001 to 2019. The results show that the health care resources in the Yangtze River Delta grew rapidly during the study period and the regional balance was improved; the overall pattern was consistent with the "Z" spatial structure of Yangtze River Delta; the factors affecting the health care resources supply cover social, economic and political dimensions, and there was spatial heterogeneity in the intensity of their effects. On this basis, it proposes strategies to promote the integrated development of medical services in Yangtze River Delta.

Key words: medical resources    regional differences    multi-scale geographic weighted regression    Yangtze River Delta
收稿日期: 2022-11-10 出版日期: 2024-01-10
CLC:  F 127  
作者简介: 陈玉娟(1970—),ORCID:https://orcid.org/0009-0002-1470-5223,女,硕士,副教授,主要从事城乡规划与设计研究,E-mail:cyjterry@126.com.
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引用本文:

陈玉娟,王志斌,周启俊,瞿建平,陈加正. 长三角地区医疗卫生资源供给的时空演化特征及其影响因素[J]. 浙江大学学报(理学版), 2024, 51(1): 76-89.

Yujuan CHEN,Zhibin WANG,Qijun ZHOU,Jianping QU,Jiazheng CHEN. Study on the spatio-temporal evolution characteristics and influencing factors of medical resource supply in the Yangtze River Delta region. Journal of Zhejiang University (Science Edition), 2024, 51(1): 76-89.

链接本文:

https://www.zjujournals.com/sci/CN/10.3785/j.issn.1008-9497.2024.01.009        https://www.zjujournals.com/sci/CN/Y2024/V51/I1/76

图1  长三角地区医疗卫生资源供给水平及其增长率
图2  2000—2019年长三角地区医疗卫生资源总差异、区域差异泰尔指数
图3  2000—2019年长三角地区地级及以上城市医疗卫生资源变化图注 底图来源于自然资源部标准地区服务系统(https://bzdt.ch.mnr.gov.cn/index.html),审图号为GS(2020)3189号,底图无修改。
图4  2000—2019年长三角地区医疗床位供给不同等级城市差异泰尔指数
图5  2000—2019年长三角地区医疗卫生资源演化格局注 底图来源于自然资源部标准地图服务系统(https://bzdt.ch.mnr.gov.cn/index.html),审图号为GS(2020)3189号,底图无修改。
图6  医疗卫生资源供给的LISA集聚图注 底图来源于自然资源部标准地图服务系统(https://bzdt.ch.mnr.gov.cn/index.html),审图号为GS(2020)3189号,底图无修改。
变量类型变量名称计算

被解释

变量

医疗卫生资源供给水平医疗床位数/年平均人口(床/万人)

解释

变量

人均GDP当年地区生产总值/年平均人口(元/人)
城镇居民人均可支配收入
床均医疗卫生支出医疗卫生支出/医疗床位数(元/床)
人口密度年平均人口/市域总面积(人/km2
城镇化增长率当年城镇化率-前一年城镇化率
政府财政压力(当年预算收入-当年预算支出)/当年地区生产总值
表1  变量及计算
变量共线性统计
容差VIF
人均GDP0.1685.911
人口密度0.5851.268
城镇化增长率0.6821.400
地方财政压力0.5142.094
城镇居民人均可支配收入0.2064.933
床均医疗卫生支出0.7101.409
表2  多重共线性检验结果
年份解释变量BandwidthResidual SquaresEffective NumberSigmaAICcR2Adjustment R2
2011人均GDP15.2108.8919.4260.53383.0050.7810.713
人口密度1.490
床均医疗卫生支出15.200
2015人均GDP3.33011.1947.5740.57985.4990.7270.663
城镇化增长率15.200
床均医疗卫生支出15.200
2019人均GDP3.8708.5489.230.51980.2510.7920.729
表3  MGWR模型拟合结果
图7  影响因素作用强度空间格局演变图注 底图来源于自然资源部标准地图服务系统(https://bzdt.ch.mnr.gov.cn/index.html),审图号为GS(2020)3189号,底图无修改。
年份解释变量平均值标准差最小值中位数最大值
2011人均GDP0.7950.0010.7940.7950.796
人口密度0.3620.1010.1590.4270.440
床均医疗卫生支出-0.0750.001-0.078-0.075-0.073
2015人均GDP0.4820.0270.4270.4840.542
城镇化增长率-0.3080.001-0.310-0.308-0.305
床均医疗卫生支出-0.9350.259-1.412-0.777-0.646
2019人均GDP0.5070.0300.4540.5090.563
表4  显著因子MGWR模型回归系数统计结果
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