中国改革开放以来,全国的大城市一直在经历与有限的医疗资源有关的问题。这些资源限制是由于人口快速增长和城市扩张。作为全国发展最快的城市,深圳经历了医疗服务供需之间的严重错位。许多研究人员通过关注医疗设施的空间可达性来分析医疗服务中的空间不平等,比如医院,诊所,和社区卫生服务中心(CHSC)。然而,弱势群体医疗服务不公平的问题在很大程度上被忽视了。我们选择了综合医院(GHs)和CHSC,为居民提供直接医疗服务,作为研究对象。通过使用重力模型和两步浮动集水面积法进行空间可达性分析,我们基于四个维度调查了弱势群体的医疗服务不平等:住宅类型,年龄,教育水平,和职业。我们发现GHs提供的服务无法满足深圳的需求。这种不足的特征是空间集中和忽视那些居住在城中村的人,教育水平低的人,他们受雇于制造业。相比之下,CHSC通常服务于相对广泛的群体。这种现象与GHs和CHSC之间的土地和资本需求差异有关。我们的研究表明,适当调整GH位置可以显着改善医疗服务不平等。因此,为了缓解这种不平等,特别有必要增加外围圈和弱势群体众多地区的GHs数量,加快实施分级医疗制度,并通过CHSC促进医疗资源向基层机构的转移。这项研究有助于提高我们对快速扩张的城市医疗服务不平等的理解,这对改善医疗设施的规划和建设具有重要意义,促进科学决策,促进社会公平。
Since the onset of reform and opening up in China, large cities in the nation have been experiencing problems related to limited medical resources. These resource limitations are due to rapid population growth and urban expansion. As the country\'s fastest growing city, Shenzhen has experienced a substantial misalignment between the supply and the demand of healthcare services. Numerous researchers have analyzed spatial
inequity in healthcare services by focusing on the spatial accessibility of medical facilities, such as hospitals, clinics, and community health service centers (CHSCs). However, the issue of
inequity in healthcare services for vulnerable groups has largely been ignored. We chose general hospitals (GHs) and CHSCs, which provide direct healthcare services to residents, as the study objects. By performing spatial accessibility analysis using the gravity model and the two-step floating catchment area method, we investigated healthcare services
inequity for vulnerable groups based on four dimensions: residential type, age, education level, and occupation. We found that the services provided by GHs cannot meet the demand in Shenzhen. This inadequacy is characterized by spatial centralization and neglect of those who reside in urban villages, who have low education levels, and who are employed in the manufacturing industry. In contrast, CHSCs generally serve a relatively broad population. This phenomenon is related to differences in the land and capital needs between GHs and CHSCs. Our study reveals that an appropriate adjustment of GH location could significantly improve healthcare services inequity. Therefore, to alleviate this
inequity, it is particularly necessary to increase the number of GHs in the peripheral circle and in areas with large vulnerable populations, accelerate the implementation of the hierarchical medical system, and promote the transfer of medical resources to grassroot institutes through CHSCs. This study helps improve our understanding of healthcare services
inequity in rapid expanding cities, which is of substantial significance for improving the planning and construction of medical facilities, facilitating scientific decision-making, and promoting social equity.