Please wait a minute...
浙江大学学报(工学版)  2021, Vol. 55 Issue (11): 2194-2206    DOI: 10.3785/j.issn.1008-973X.2021.11.021
土木与建筑工程     
基于个人选择偏好的城市医疗资源配置分析
程明骏1(),朱云辰1,2,岑沛立3,黄杉1,2,*()
1. 浙江大学 建筑设计研究院有限公司, 浙江 杭州 310027
2. 浙江大学 平衡建筑研究中心, 浙江 杭州 310027
3. 浙江大学医学院附属第二医院, 浙江 杭州310009
Allocation of urban medical resources based on personal choice preference
Ming-jun CHENG1(),Yun-chen ZHU1,2,Pei-li CEN3,Shan HUANG1,2,*()
1. The Architectural Design and Research Institute of Zhejiang University Limited Company, Hangzhou 310027, China
2. Center for Balance Architecture, Zhejiang University, Hangzhou 310027, China
3. 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
 全文: PDF(1254 KB)   HTML
摘要:

在健康城市与新冠疫情的大背景下,须研究医疗资源空间配置的方法论. 以杭州市为例,采用改进后的高斯两步移动搜索法(2SFCA),以“从供到求”的视角来研究公共医疗资源空间分配情况,并结合计划行为理论(TPB),以“从求到供”的视角来研究个人选择偏好对医疗资源配置的影响. 结果表明,杭州市医疗资源具有明显的中心集聚性,居民可获得的医疗资源总量和医院的医疗资源被挤兑与否及程度相关,证明了居民个人意愿对城市医疗资源分配的影响. 分析结果对当前《杭州市区医疗卫生设施布局规划(2016—2035)》的医疗设施布点方案进行合理性分析与局部优化,提升了布点方案的科学性。

关键词: 医疗资源高斯两步移动搜索法计划行为理论个人选择偏好杭州    
Abstract:

New methods of spatial allocation of medical resources should be investigated under the background of healthy cities and COVID-19 pandemic. Hangzhou was taken as an example and the improved Gaussian two-step floating catchment area method (2SFCA) was used to study the space allocation of public medical resources from the perspective of “supply to demand”. And the theory of planned behavior (TPB) was used as represent of personal choice preference to study the influence of personal choice behavior on the medical resources from the perspective of “demand to supply”. Results show that Hangzhou’s medical resources have obvious central agglomeration, and the total amount of medical resources available to residents is related to whether the hospital’s medical resources are run on and the extent. Meanwhile, it is proved that residents’ personal choice has an impact on the allocation of urban medical resources. The analysis results can be the optimization to the medical facility distribution scheme of the current “Hangzhou Urban Medical and Health Facility Layout Planning (2016—2035)”, which has analyzed the rationality and also improved the scientificity of the distribution scheme.

Key words: medical resource    two-step floating catchment area method    theory of planned behavior    personal choice preference    Hangzhou
收稿日期: 2021-04-27 出版日期: 2021-11-05
CLC:  TU 984.2  
基金资助: 国家自然科学基金应急管理项目(71841006);2020年度浙江大学平衡建筑研究中心立项项目(K横20203314);住房和城乡建设部科技计划项目(2015-R2-061);浙江省2020年建设科研项目(2020K012)
通讯作者: 黄杉     E-mail: mkellerc@outlook.com;archer58@zju.edu.cn
作者简介: 程明骏(1995—),男,助理工程师,从事城乡规划研究. orcid.org/0000-0002-0049-4333. E-mail: mkellerc@outlook.com
服务  
把本文推荐给朋友
加入引用管理器
E-mail Alert
作者相关文章  
程明骏
朱云辰
岑沛立
黄杉

引用本文:

程明骏,朱云辰,岑沛立,黄杉. 基于个人选择偏好的城市医疗资源配置分析[J]. 浙江大学学报(工学版), 2021, 55(11): 2194-2206.

Ming-jun CHENG,Yun-chen ZHU,Pei-li CEN,Shan HUANG. Allocation of urban medical resources based on personal choice preference. Journal of ZheJiang University (Engineering Science), 2021, 55(11): 2194-2206.

链接本文:

https://www.zjujournals.com/eng/CN/10.3785/j.issn.1008-973X.2021.11.021        https://www.zjujournals.com/eng/CN/Y2021/V55/I11/2194

图 1  从“刚性供给”与“刚性需求”出发的医疗资源“分配”与“供给”两步过程
图 2  基于2SFCA与TPB的杭州市“供求双向”医疗资源可达性分析技术路线图
图 3  杭州市主城六区综合医院及路网分布图
图 4  杭州市人口点分布图
图 5  空间资源配比视角下的医疗卫生资源可达性分析图
医院名称 ${\mathit{S} }_{\mathit{j} }$/张 ${\mathit{S} }'_{\mathit{j} }$/张 ${ {S'_{ {j} } } } -{ {S} }_{ {j} }$/张 $\dfrac{ { {S'_{ {j} } } }-{ {S_{ {j} } } } } { {S_{ {j} }} } /\text{%}$ 分类
浙江省立同德医院(翠苑院区) 1200 2038.6 838.6 69.88 1)
浙江省新华医院 1200 1772.8 572.8 47.73 1)
杭州师范大学附属医院 850 1359.1 509.1 59.89 1)
浙江省人民医院(朝晖院区) 1700 2189.9 489.9 28.82 1)
浙江大学医学院附属邵逸夫医院(庆春院区) 1200 1632.9 432.9 36.07 1)
浙江大学医学院附属第二医院(滨江院区) 1200 1606.0 406.0 33.83 1)
杭州市红会医院 1000 1380.3 380.3 38.03 1)
浙江大学医学院附属邵逸夫医院(下沙院区) 1200 1565.9 365.9 30.49 1)
浙江医院(三墩院区) 1200 1488.5 288.5 24.04 1)
武警医院 490 754.0 264.0 53.88 3)
浙江大学医学院附属第一医院 2500 2737.4 237.4 9.50 4)
杭州市中医院(北山分院) 1000 1219.7 219.7 21.97 1)
浙江省中医院(下沙院区) 860 1065.0 205.0 23.83 1)
浙江大学医学院附属第二医院(解放路院区) 1000 1166.6 166.6 16.66 4)
浙江中医药大学附属第三医院(莫干山路院区) 430 590.2 160.2 37.26 3)
浙江省青春医院 300 453.4 153.4 51.13 3)
浙江省医疗健康集团杭州医院 450 601.3 151.3 33.63 3)
江干区人民医院(笕桥院区) 100 234.2 134.2 134.16 3)
杭州市中医院(丁桥院区) 500 631.2 131.2 26.24 3)
江干区人民医院(明石院区) 100 220.9 120.9 120.86 3)
树兰(杭州)医院 1000 1104.9 104.9 10.49 4)
浙江中医药大学附属第三医院 430 527.6 97.6 22.71 3)
浙江大学校医院(华家池分院) 100 194.4 94.4 94.40 3)
浙江大学校医院(紫金港校区分院) 50 123.7 73.7 147.35 3)
杭州市第一人民医院 1200 1236.9 36.9 3.08 4)
浙江大学校医院 30 40.3 10.3 34.46 3)
浙江省中医院 2060 2065.3 5.3 0.26 4)
浙江省立同德医院(之江院区) 300 272.1 ?27.9 ?9.29 2)
浙江省人民医院(望江山分院) 500 435.7 ?64.3 ?12.86 2)
浙江医院 615 464.6 ?150.4 ?24.46 2)
中国人民解放军联勤保障部队第903医院 1000 733.0 ?267.0 ?26.70 2)
杭州市西溪医院 1100 514.6 ?585.4 ?53.21 2)
表 1  杭州市综合医院现有床位数与偏好需求床位数分类对比
图 6  个人意愿选择视角下的医疗卫生资源可达性分析图
图 7  空间资源配比与个人意愿选择视角对比下的医疗卫生资源可达性变化图
1 王兰, 蒋希冀, 叶丹 中国健康城市规划研究热点与进展: 基于Citespace的文献计量分析[J]. 城市发展研究, 2020, 27 (11): 8- 14
WANG Lan, JIANG Xi-ji, YE Dan Research hotspots and progress in China's healthy city planning: a bibliometric analysis based on Citespace[J]. Urban Development Studies, 2020, 27 (11): 8- 14
doi: 10.3969/j.issn.1006-3862.2020.11.003
2 中央纪委国家监委网站. 疫情让我们重新反思城市公共卫生治理: 访中国人民大学公共管理学院教授刘鹏[EB/OL](2020-6-20). http://www.ccdi.gov.cn/toutiao/202006/t20200619_220454.html.
3 HUFF D L A probabilistic analysis of shopping center trade areas[J]. Land Economics, 1963, 39 (1): 81- 90
doi: 10.2307/3144521
4 HUFF D L Defining and estimating a trading area[J]. Journal of Marketing, 1964, 28 (3): 34- 38
doi: 10.1177/002224296402800307
5 AUSTIN C M The evaluation of urban public facility location: an alternative to benefit-cost analysis[J]. Geographical Analysis, 1974, 6 (2): 135- 145
6 MCALLISTER D M Equity and efficiency in public facility location[J]. Geographical Analysis, 1976, 8 (1): 47- 63
7 KHAN A A An integrated approach to measuring potential spatial access to health care services[J]. Socio-economic Planning Sciences, 1992, 26 (4): 275- 287
doi: 10.1016/0038-0121(92)90004-O
8 RADKE J, MU L Spatial decompositions, modeling and mapping service regions to predict access to social programs[J]. Geographic Information Sciences, 2000, 6 (2): 105- 112
9 MATTHEW R M, JOHN S H Measuring spatial accessibility to primary care in rural areas: improving the effectiveness of the two-step floating catchment area method[J]. Applied Geography, 2008, 29 (4): 533- 541
10 GUAGLIARDO M F, RONZIO C R, CHEUNG I, et al Physician accessibility: an urban case study of pediatric providers[J]. Health and Place, 2004, 10 (3): 273- 283
doi: 10.1016/j.healthplace.2003.01.001
11 LUO W, QI Y An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians[J]. Health and Place, 2009, 15 (4): 1100- 1107
doi: 10.1016/j.healthplace.2009.06.002
12 DAI D Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit[J]. Health and Place, 2010, 16 (5): 1038- 1052
doi: 10.1016/j.healthplace.2010.06.012
13 WAN N, ZHAN F B, ZOU B, et al A relative spatial access assessment approach for analyzing potential spatial access to colorectal cancer services in Texas[J]. Applied Geography, 2012, 32 (2): 291- 299
doi: 10.1016/j.apgeog.2011.05.001
14 DELAMATER P L, SHORTRIDGE A M, KILCOYNE R C Using floating catchment area (FCA) metrics to predict health care utilization patterns[J]. BMC Health Services Research, 2019, 19 (1): 1- 14
doi: 10.1186/s12913-018-3827-x
15 DONG Y, FU L, TAN R, et al The dilemma of medical reimbursement policy in rural China: spatial variability between reimbursement region and medical catchment area[J]. International Journal of Environmental Research and Public Health, 2019, 16: 2867
doi: 10.3390/ijerph16162867
16 宋正娜, 陈雯, 张桂香, 等 公共服务设施空间可达性及其度量方法[J]. 地理科学进展, 2010, (10): 1217- 1224
SONG Zheng-na, CHEN Wen, ZHANG Gui-xiang, et al Spatial accessibility to public service facilities and its measurement approaches[J]. Progress in Geography, 2010, (10): 1217- 1224
doi: 10.11820/dlkxjz.2010.10.009
17 唐子来, 顾姝 再议上海市中心城区公共绿地分布的社会绩效评价: 从社会公平到社会正义[J]. 城市规划学刊, 2016, (1): 15- 21
TANG Zi-lai, GU Shu An evaluation of social performance in the distribution of urban parks in the central city of Shanghai: from social equity to social justice[J]. Urban Planning Forum, 2016, (1): 15- 21
18 邢忠, 朱嘉伊 基于耦合协调发展理论的绿地公平绩效评估[J]. 城市规划, 2017, (11): 89- 96
XING Zhong, ZHU Jia-yi Evaluation on fair performance of urban green space based on coupling model of coordinated development theory[J]. City Planning Review, 2017, (11): 89- 96
19 张京祥, 葛志兵, 罗震东, 等 城乡基本公共服务设施布局均等化研究: 以常州市教育设施为例[J]. 城市规划, 2012, (2): 9- 15
ZHANG Jing-xiang, GE Zhi-bing, LUO Zhen-dong, et al Research on equalized layout of urban and rural public facilities: a case study of educational facilities in Changzhou[J]. City Planning Review, 2012, (2): 9- 15
doi: 10.3969/j.issn.1000-3363.2012.02.002
20 陈伟东, 张大维 中国城市社区公共服务设施配置现状与规划实施研究[J]. 人文地理, 2007, (5): 29- 33
CHEN Wei-dong, ZHANG Da-wei A research into the present situation and plan implementation of the urban public service facilities’ disposition in China[J]. Human Geography, 2007, (5): 29- 33
doi: 10.3969/j.issn.1003-2398.2007.05.005
21 侯松岩, 姜洪涛 基于城市公共交通的长春市医院可达性分析[J]. 地理研究, 2014, 33 (5): 915- 925
HOU Song-yan, JIANG Hong-tao Analysis of hospital accessibility in Changchun city based on urban public transportation[J]. Geographical Research, 2014, 33 (5): 915- 925
doi: 10.11821/dlyj201405010
22 应联行 杭州城市社区现状及公共服务设施研究[J]. 规划师, 2004, 20 (5): 93- 96
YING Lian-xing A study on the present status of urban communities and public service facilities of Hangzhou[J]. Planners, 2004, 20 (5): 93- 96
doi: 10.3969/j.issn.1006-0022.2004.05.025
23 王远飞, 张超 GIS和引力多边形方法在公共设施服务域研究中的应用: 以上海浦东新区综合医院为例[J]. 经济地理, 2005, (6): 800- 803
WANG Yuan-fei, ZHANG Chao GIS and gravity polygon based service area analysis of public facility: case study of hospitals in Pudong New Area[J]. Economic Geography, 2005, (6): 800- 803
doi: 10.3969/j.issn.1000-8462.2005.06.012
24 刘钊, 郭苏强, 金慧华, 等 基于GIS的两步移动搜寻法在北京市就医空间可达性评价中的应用[J]. 测绘科学, 2007, 32 (1): 61- 63
LIU Zhao, GUO Su-qiang, JIN Hui-hua, et al Application of the GIS-based two-step floating catchment area method in measurement of spatial accessibility to hospitals in Beijing[J]. Science of Surveying and Mapping, 2007, 32 (1): 61- 63
doi: 10.3771/j.issn.1009-2307.2007.01.023
25 程敏, 黄维维 基于高斯两步移动搜索法的上海市养老设施空间可达性评价[J]. 复旦学报:自然科学版, 2020, 59 (2): 129- 136
CHENG Min, HUANG Wei-wei Measuring the accessibility of residential care facilities in shanghai based on gaussian two-step floating catchment area method[J]. Journal of Fudan University: Natural Science, 2020, 59 (2): 129- 136
26 任家怿, 王云 基于改进两步移动搜索法的上海市黄浦区公园绿地空间可达性分析[J]. 地理科学进展, 2021, 40 (5): 774- 783
REN Jia-yi, WANG Yun Spatial accessibility of park green space in Huangpu District of Shanghai: based on modified two-step floating catchment area method[J]. Progress in Geography, 2021, 40 (5): 774- 783
doi: 10.18306/dlkxjz.2021.05.005
27 国务院. 《全国医疗卫生服务体系规划纲要(2015—2020年)》[EB/OL](2015-03-06). http://www.gov.cn/zhengce/content/2015-03/30/content_9560.htm.
28 国务院. 健康中国2030规划纲要[EB/OL](2016-12-30). http://www.mohrss.gov.cn/SYrlzyhshbzb/zwgk/ghcw/ghjh/201612/t20161230_263500.html.
29 FISHBEIN M An investigation of the relationships between beliefs about an object and the attitude toward that object[J]. Human Relations, 1963, 16 (3): 233- 239
doi: 10.1177/001872676301600302
30 FISHBEIN M, AJZEN I Belief, attitude, intention, and behavior: an introduction to theory and research[J]. Journal of Business Venturing, 1977, (5): 177- 189
31 AJZEN I The theory of planned behavior[J]. Organizational Behavior and Human Decision Processes, 1991, 50 (2): 179- 211
doi: 10.1016/0749-5978(91)90020-T
32 段文婷, 江光荣 计划行为理论述评[J]. 心理科学进展, 2008, (2): 315- 320
DUAN Wen-ting, JIANG Guang-rong A review of the theory of planned behavior[J]. Advances in Psychological Science, 2008, (2): 315- 320
33 MOSCELLI G, SICILIANI L, GUTACKER N, et al Location, quality and choice of hospital: evidence from England 2002–2013[J]. Regional Science and Urban Economics, 2016, 60: 112- 124
doi: 10.1016/j.regsciurbeco.2016.07.001
34 聂静虹, 金恒江 病患就医意愿和健康意向的影响因素研究: 基于计划行为理论(TPB)模型的构建[J]. 新闻大学, 2017, (5): 91- 99
NIE Jing-hong, JIN Heng-jiang Analysis of the influencing factors of patient to medical care and health intention: based on planned behavior theory[J]. Journalism Research, 2017, (5): 91- 99
35 李早, 高岩琰, 崔巍懿, 等 城市医疗设施布点的可达性分析及其适老化发展研究: 以合肥市为例[J]. 建筑与文化, 2019, (5): 136- 140
LI Zao, GAO Yan-yan, CUI Wei-yi, et al Study on the accessibility of urban medical facilities layout and their elderly-oriented development: take Hefei City as an example[J]. Architecture and Culture, 2019, (5): 136- 140
doi: 10.3969/j.issn.1672-4909.2019.05.048
36 申悦, 史祎雯, 王虹翔, 等 医疗设施可达性对患者就医空间的影响研究: 基于上海市医院患者调查的实证[J]. 城市发展研究, 2019, 26 (12): 46- 52
SHEN Yue, SHI Yi-wen, WANG Hong-xiang, et al The impacts of medical facility accessibility on patients’ medical treatment space: a case study in Shanghai[J]. Urban Development Studies, 2019, 26 (12): 46- 52
doi: 10.3969/j.issn.1006-3862.2019.12.006
37 王天圻 基于GIS的增强型两步移动搜索法分析: 以格拉斯哥市的英国国家医疗服务体系(NHS)可达性为例[J]. 城市勘测, 2020, (1): 39- 44
WANG Tian-qi Evaluating the accessibility of national health services in glasgow: a GIS based study of enhanced two-step floating catchment area[J]. Urban Geotechnical Investigation and Surveying, 2020, (1): 39- 44
doi: 10.3969/j.issn.1672-8262.2020.01.010
38 陈龙, 张志斌, 张亚丽, 等 城市公共服务设施与居住小区空间匹配性研究: 以兰州市为例[J]. 干旱区资源与环境, 2019, 33 (11): 120- 127
CHEN Long, ZHANG Zhi-bin, ZHANG Ya-li, et al The rationality of spatial configuration of public service facilities in Lanzhou[J]. Journal of Arid Land Resources and Environment, 2019, 33 (11): 120- 127
39 蒋海兵, 张文忠, 韦胜 公共交通影响下的北京公共服务设施可达性[J]. 地理科学进展, 2017, (10): 57- 67
JIANG Hai-bing, ZHANG Wen-zhong, WEI Sheng Public service facility accessibility as influenced by public transportation in Beijing[J]. Progress in Geography, 2017, (10): 57- 67
40 重庆市卫生健康委员会. 多措并举, 全力推进基本公共卫生服务工作[EB/OL](2020-11-30). http://wsjkw.cq.gov.cn/ztzl_242/jcws/jcfc/202011/t20201130_8512529_wap.html.
41 宁波市卫生健康委员会. 宁波市卫生健康委关于印发2021年全市卫生健康工作要点的通知[EB/OL](2021-03-12). http://wjw.ningbo.gov.cn/art/2021/3/12/art_1229128278_58922181.html.
[1] 李莉, 操进浪, 贺治国, 姚炎明. 杭州湾-长江口海域岸线变化对杭州湾潮汐特征的影响[J]. 浙江大学学报(工学版), 2018, 52(8): 1605-1615.
[2] 谢东风, 潘存鸿, 鲁海燕, 王立辉, 唐子文. 钱塘江河口涌潮传播速度研究[J]. J4, 2012, 46(6): 1128-1134.
[3] 王繁 凌在盈 周斌 宋立松 王新. 监测河口水体悬浮泥沙质量浓度的短期变异[J]. , 2009, 43(4): 755-759.
[4] 王繁 周斌 徐建明 宋立松 王新. 杭州湾悬浮泥沙浓度垂向分布规律分析与模拟[J]. J4, 2008, 42(11): 2028-2032.
[5] 陈衡治 谢旭 张治成 叶贵如 徐兴. 预应力混凝土箱梁桥的温度场和应力场[J]. J4, 2005, 39(12): 1885-1890.