中国全科医学 ›› 2025, Vol. 28 ›› Issue (02): 234-241.DOI: 10.12114/j.issn.1007-9572.2023.0624

• 论著·卫生服务质量改进研究 • 上一篇    下一篇

基于医疗服务半径的中医类医疗机构空间配置及优化研究:以广州市增城区为例

李成程, 周尚成*(), 贺凯玥, 刘爱玲, 梁珊珊, 高婧, 钟艾霖   

  1. 510006 广东省广州市,广州中医药大学公共卫生与管理学院
  • 收稿日期:2023-07-10 修回日期:2023-12-15 出版日期:2025-01-15 发布日期:2024-10-28
  • 通讯作者: 周尚成

  • 作者贡献:

    李成程进行文章的构思、绘图和数据分析并撰写论文初稿;贺凯玥和刘爱玲负责资料的收集;梁珊珊负责数据的清洗和整理;高婧进行论文修订;钟艾霖负责整理文献;周尚成负责文章的质量控制与审校。

  • 基金资助:
    国家自然科学基金资助项目(71774079,81973979); 广东省自然科学基金资助项目(2019A1515011496); 广东省社科基金项目(GD19CSH04)

A Study of Space Allocation and Optimization of Traditional Chinese Medical Institutions Based on Medical Service Radius: a Case Study of Zengcheng District, Guangzhou City

LI Chengcheng, ZHOU Shangcheng*(), HE Kaiyue, LIU Ailing, LIANG Shanshan, GAO Jing, ZHONG Ailin   

  1. School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
  • Received:2023-07-10 Revised:2023-12-15 Published:2025-01-15 Online:2024-10-28
  • Contact: ZHOU Shangcheng

摘要: 背景 随着中国传统医学纳入国际疾病分类第十一次修订本(ICD-11)编码,基层中医医疗资源的合理配置是推动中西医融合和优质医疗资源全民覆盖的保障。基层医疗机构布局和服务能力不均衡,导致城市乡镇地区普遍存在医疗资源供需错位问题。 目的 了解我国乡镇中医药服务开展状况,科学评价基层中医药诊疗的覆盖范围和服务可及性,为优化基层中医药服务空间资源配置提供新思路并据此提出优化策略。 方法 基于第七次全国人口普查数据和点状地理空间数据,引入医疗服务半径概念来计算步行模式下不同层级中医类医疗机构的诊疗范围。采用空间核密度指数、空间标准差椭圆等方法揭示中医类医疗服务供需能力的空间公平性。基于以上结果提出中医类医疗资源布局优化类型及措施。 结果 截至2022年增城区共计医疗机构699家,其中带有床位的中医类医疗机构18家,不同乡镇、街道的中医类医疗机构床位分布呈现出较大的差异。中滩镇千人口床位数为14.31张,在所有街道中排在第一位。永宁街道千人口床位数排在末位,仅为0.89张。增城区中医类医疗机构呈现出明显的双中心格局,中新镇中部、派潭镇北部和石滩镇西南部居民的中医药服务可获得性较弱。不同乡镇的中医药服务供给能力差别较大,中医类医疗机构空间分布同城镇居民的整体空间聚集程度还存在一定程度的不吻合,不同乡镇间的中医药服务半径存在差异。 结论 中医药发展战略实施以来,中国传统医学得到了保护和发展。应当采取更为科学的策略将中医药服务同城市发展和居民需求紧密结合,积极采取增加设施点、资源转移和下沉相结合、跨区域的中医药信息化联合诊疗的差异化策略,逐步实现真正意义上的全覆盖和中西医并重的战略。

关键词: 中医医疗机构, 医疗服务半径, 基层中医药服务, 空间标准差椭圆, 空间优化

Abstract:

Background

As China's Traditional medicine is included in the ICD-11 code, the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas.

Objective

Understand the development status of traditional Chinese medicine services in rural areas of China, scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment, provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services, and propose optimization strategies accordingly.

Methods

Based on the seventh national population census data and path planning data, the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results, propose types and measures for optimizing the layout of traditional Chinese medicine medical resources.

Results

As of 2022, there are a total of 699 medical institutions in Zengcheng District, including 18 traditional Chinese medicine medical institutions with beds. There were significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile, the number of beds per thousand population in Zhongtan Town was 14.31, ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last, with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District had shown a clear dual center pattern, with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town, the northern part of Paitan Town, and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There was still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There were differences in the radius of traditional Chinese medicine services between different townships.

Conclusion

Since the implementation of the development strategy of traditional Chinese medicine, China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points, combining resource transfer and sinking, and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions, gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.

Key words: Medical organizations (TCM), Medical service radius, Grassroots traditional Chinese medicine services, Spatial standard deviation ellipse, Space optimization

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