基于地理探测器的欠发达地区健康资源时空分异及影响因素研究

doi:10.12118/j.issn.1000–6060.2021.02.30

Abstract

Abstract:

Medical resources are the foundation of a quality health service system which in turn ensures a safe and secure community, therefore, it is important to study regional differences in medical resources and identify the factors that influence them to optimize the planning and distribution of these resources for strategic deployment of the Healthy China Action Plan. Using Gansu Province, China as an example, the coefficient of variation, the Gini coefficient, the Theil index, and the form of decomposition as well as the agglomeration degree of health resources and spatiotemporal differences in the level and equilibrium of medical resources were analyzed for Gansu from 2010 to 2017. The factors affecting the spatial distribution of medical resources were identified using GeoDetector. The results reveal five important facts: (1) From 2010 to 2017, the level and equilibrium of medical resources in Gansu Province increased by 14.96%, which laid the foundation for equal access to basic public services, thereby improving the public service system. The growth rates of medical resources in Hexi, Longzhong, Longdong, and Longnan areas were 24.60%, 11.51%, 14.91%, and 12.28%, respectively, of which the Hexi area showed the most significant growth. (2) The level and equilibrium of allocation of medical resources presented a pattern of southeast superior to northwest. The level and equilibrium of medical resources in Longdong and Longzhong, which are areas of high economic status, were higher than the levels and equilibria in other areas, among which Lanzhou, Pingliang, and Longnan had relatively high equilibrium. (3) The level and equilibrium of medical resources per capita were better than those for individual geographic locales within Gansu Province, especially in the Hexi area because of its vast area and relatively small population which creates a per capita balance that is better than the average balance for the entire province. (4) The overall difference gradually decreased in Gansu Province over time, and consequently the balance of medical resources improved. At the same time, intraregional differences decreased but the regional difference gradually increased. The regional difference is the main contributor to the overall difference in Gansu. (5) Economic factors are the main factors impacting medical resources and the factors used to explain the interaction between the real GDP per capita, population aging, and other factors. The influence of natural factors on medical resources increased each year. The level of medical resources in regions of high economic status was relatively balanced, while remote areas had low levels of medical resources due to geographical and environmental constraints.

Key words: medical resources, equilibrium, regional differences, geodetectors

ZHAO Haili,WANG Qiwen,ZHU Lixiang,LI Xiaoqin,TIAN Haoyu. Spatial-temporal evolution and influencing factors of health resources in underdeveloped areas based on geodetectors[J].Arid Land Geography, 2021, 44(2): 594-603.

Figures/Tables 7

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References 35

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泰尔指数		2010年	2011年	2012年	2013年	2014年	2015年	2016年	2017年
差异	总差异	0.179	0.164	0.176	0.175	0.177	0.161	0.163	0.166
	区域间	0.085	0.080	0.080	0.080	0.086	0.085	0.093	0.094
	区域内	0.095	0.085	0.096	0.096	0.091	0.076	0.070	0.073
	河西	0.052	0.045	0.052	0.048	0.045	0.046	0.040	0.036
	陇中	0.019	0.018	0.019	0.017	0.015	0.012	0.011	0.016
	陇东	0.010	0.008	0.013	0.018	0.016	0.011	0.011	0.012
	陇南	0.014	0.013	0.012	0.013	0.015	0.007	0.008	0.008
贡献度/%	区域间	47.310	48.520	45.560	45.410	48.520	52.630	57.000	56.280
贡献度/%	区域内	52.690	51.480	54.440	54.590	51.480	47.370	43.000	43.720

目标层	要素层	指标层	数据来源/单位
医疗卫生资源配置影响因素	社会经济发展	x₁	统计年鉴/元
		x₂	统计年鉴/% 统计年鉴/% 统计年鉴/% 统计年鉴/% 统计年鉴/%
		x₃
	人口分布	x₄
	人口分布	x₅
	地形	x₆	GIS提取/°
	地形	x₇	GIS提取/m

年份	x₁	x₂	x₃	x₄	x₅	x₆	x₇
2010	0.800*	0.790**	0.089	0.873***	0.377	0.121	0.207
2011	0.787*	0.740**	0.318	0.877***	0.320	0.139	0.218
2012	0.738	0.848***	0.236	0.832**	0.520	0.107	0.195
2013	0.737	0.806**	0.583	0.796**	0.343	0.133	0.219
2014	0.697	0.827***	0.197	0.789**	0.448	0.136	0.212
2015	0.755	0.813***	0.432	0.835**	0.132	0.195	0.263
2016	0.822**	0.906***	0.300	0.847**	0.162	0.224	0.295
2017	0.858**	0.685	0.547	0.873***	0.093	0.303	0.250

2010年		2013年		2015年		2017年
交互因子	作用值	交互因子	作用值	交互因子	作用值	交互因子	作用值
x₂ ∩ x₅	1.000	x₁ ∩ x₅	1.000	x₃ ∩ x₅	1.000	x₁ ∩ x₂	0.992
x₄ ∩ x₅	0.999	x₄ ∩ x₅	1.000	x₁ ∩ x₅	0.999	x₂ ∩ x₄	0.992
x₁ ∩ x₅	0.989	x₄ ∩ x₆	0.979	x₄ ∩ x₅	0.996	x₄ ∩ x₅	0.988
x₁ ∩ x₃	0.982	x₃ ∩ x₅	0.976	x₃ ∩ x₄	0.989	x₃ ∩ x₄	0.980
x₃ ∩ x₄	0.982	x₂ ∩ x₆	0.953	x₂ ∩ x₅	0.960	x₂ ∩ x₃	0.960
x₂ ∩ x₄	0.962	x₃ ∩ x₄	0.946	x₂ ∩ x₄	0.952	x₁ ∩ x₅	0.959
x₁ ∩ x₆	0.949	x₂ ∩ x₄	0.943	x₄ ∩ x₆	0.946	x₅ ∩ x₆	0.952
x₁ ∩ x₂	0.942	x₁ ∩ x₂	0.940	x₁ ∩ x₃	0.945	x₅ ∩ x₇	0.952
x₂ ∩ x₃	0.938	x₂ ∩ x₅	0.937	x₅ ∩ x₆	0.941	x₂ ∩ x₆	0.934
x₁ ∩ x₇	0.934	x₄ ∩ x₇	0.934	x₅ ∩ x₇	0.941	x₂ ∩ x₇	0.934

Spatial-temporal evolution and influencing factors of health resources in underdeveloped areas based on geodetectors

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