地理科学进展 ›› 2018, Vol. 37 ›› Issue (8): 1075-1085.doi: 10.18306/dlkxjz.2018.08.007

所属专题: 人口与城市研究

• 研究论文 • 上一篇    下一篇

医疗设施可达性空间差异及其影响因素——基于上海市户籍与流动人口的对比

陶印华1,2(), 申悦2,3,*()   

  1. 1. 北京大学 城市与环境学院,北京 100871
    2. 华东师范大学 城市与区域科学学院,上海 200062
    3. 华东师范大学 中国现代城市研究中心,上海 200062
  • 收稿日期:2017-08-02 修回日期:2017-12-19 出版日期:2018-09-04 发布日期:2018-09-04
  • 通讯作者: 申悦 E-mail:amo784851328@163.com;shenyue0519@163.com
  • 作者简介:

    作者简介:陶印华(1995-),男,上海人,硕士研究生,主要研究城市地理学与行为地理学,E-mail: amo784851328@163.com

  • 基金资助:
    国家自然科学基金项目(41501180,41571144,41871166);上海市教育发展基金会和上海市教育委员会“晨光计划”项目(17CG20);上海市城市更新及其空间优化技术重点实验室开放课题(201830205)

Spatial difference of medical facility accessibility and influencing factors: A comparative study of registered and floating populations in Shanghai

Yinhua TAO1,2(), Yue SHEN2,3,*()   

  1. 1. College of Urban and Environment Sciences, Peking University, Beijing 100871, China
    2. School of Urban and Regional Science, East China Normal University, Shanghai 200062, China
    3. The Center for Modern Chinese City Studies, East China Normal University, Shanghai 200062, China
  • Received:2017-08-02 Revised:2017-12-19 Online:2018-09-04 Published:2018-09-04
  • Contact: Yue SHEN E-mail:amo784851328@163.com;shenyue0519@163.com
  • Supported by:
    National Natural Science Foundation of China, No.41501180, No.41571144, No.41871166;"Chenguang Program" Supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission, No.17CG20;Open Projects Fund of Key Laboratory of Shanghai Urban Renewal and Spatial Optimization Technology, No.201830205

摘要:

医疗设施可达性关乎民生健康、生活质量和社会公平等重大社会议题,受到广泛关注。将空间视角和社会视角相结合,考虑流动人口和户籍人口在城市不同区域内可达性的差异,将有助于更加全面地反映当前城市医疗服务的资源配置及其社会公平问题。本文以上海市不同等级医疗设施的可达性为研究对象,利用改进潜能模型和多元线性回归模型,分析了城市中不同区域内医疗设施的可达性、户籍人口和流动人口就医可达性差异及其影响机理。研究发现:医疗设施可达性自内城区向郊区逐渐降低,郊区可达性的波动程度较大;户籍人口的就医可达性优于流动人口,2类人群的差异在中心城边缘区和近郊区最为明显;居住地区位显著影响居民的就医可达性,但对于户籍人口的影响更加显著。本文可为上海市医疗资源的空间配置优化和改善流动人口就医条件提供实证研究依据。

关键词: 医疗设施, 就医可达性, 社会公平, 改进潜能模型, 上海

Abstract:

Since the central government proposed "balancing basic public services" in 2006 and the 2009 World Bank Development Report advocated "equal coverage of residents' access to public services," improving facility accessibility and spatial distribution have increasingly become one of the development goals for regional governments and hot topics for academic research. In Shanghai Municipality, accessibility of medical facilities in different regions within the city needs to be examined urgently because it is closely related to people's livelihood, health, and social justice. Based on the accessibility of tertiary, secondary, and community hospitals in Shanghai, this study analyzed the accessibility of medical facilities in different areas of the city, and the variation between the registered and floating populations. Improved potential model and multivariate linear regression model are used accordingly. The study further explored the influencing mechanism of individual accessibility of medical treatment. The results are as follows. First, the inner city is characterized by the highest regional accessibility of medical facilities, and accessibility is gradually reduced from the inner city to the suburbs. The fluctuation of hospital accessibility is relatively clear in the suburban area. Anting Town, Huaxin Town, and some other towns in the west of Shanghai still lack of medical facilities. Second, registered population's accessibility of medical treatment is better than that of floating population, and the most obvious difference between the two groups is found in the fringe of the central urban area and the inner suburban areas. Compared to the Pudong area, floating population in the Puxi area is facing more difficulties in seeking medical care. Third, residential location significantly affects accessibility of medical treatment. For the registered population, community hospitals are more accessible in outer suburbs, and secondary hospitals are more accessible in the fringe of the central urban area compared with the inner suburbs. For the floating population, the above variation is not significant. No matter which regions they live, they are generally facing severe medical accessibility problems. Finally, socioeconomic and institutional factors also have impacts on accessibility to medical facilities. Middle-aged and elderly residents with higher education have better access to medical facilities. Housing property rights and medical insurance are much related to registered population's medical accessibility, while economic factors matter more for floating population. This study provides some suggestions for the relevant government departments to identify areas lacking medical facilities and improve the spatial distributions of medical and public transport facilities, thus helping to achieve the goal of equal access of health care. Future studies need to consider the integrated impact of spatial and institutional factors on residents' medical preferences and behaviors.

Key words: medical facility, medical accessibility, social equity, improved potential model, Shanghai