發(fā)布時(shí)間：2018-09-08 10:40

【摘要】：隨著老齡化進(jìn)程不斷加快,老年人這一特殊人群日益成為各領(lǐng)域關(guān)注的重點(diǎn),其中尤以醫(yī)療衛(wèi)生機(jī)構(gòu)服務(wù)為甚。包括醫(yī)療設(shè)施在內(nèi)的各類公共服務(wù)設(shè)施配置的服務(wù)半徑通常是根據(jù)全體居民的出行耗時(shí)來決定的,容易導(dǎo)致醫(yī)療設(shè)施布局超出老年人群的日常活動(dòng)范圍,從而影響了老年人群的就醫(yī)可達(dá)性�；谝陨媳尘�,本研究選取廣州市作為研究區(qū)域,以老年人群體作為研究對象,探究城市就醫(yī)可達(dá)性水平的空間分異。研究首先從需求角度出發(fā),對老年人群進(jìn)行界定,并結(jié)合行政區(qū)劃分布了解廣州市老年人口空間分布特征、老年人口數(shù)量變化情況,并通過實(shí)際的問卷調(diào)查,掌握廣州市老年人交通出行方式特征及就醫(yī)行為偏好;其次從供應(yīng)角度,對廣州市醫(yī)療機(jī)構(gòu)空間分布特征、服務(wù)能力狀況及就醫(yī)服務(wù)質(zhì)量情況進(jìn)行了研究;然后從供需結(jié)合角度,探究老年人就醫(yī)需求與醫(yī)院服務(wù)能力之間的匹配情況,結(jié)合老年人就醫(yī)需求特征,通過互聯(lián)網(wǎng)地圖獲取老年人就醫(yī)出行交通方式下的OD通行時(shí)間,構(gòu)建多種交通出行方式下的綜合交通可達(dá)性量測模型,進(jìn)一步探究廣州市老年人就醫(yī)時(shí)空可達(dá)性特征,從而判斷醫(yī)缺區(qū);最后針對老年人就醫(yī)可達(dá)性水平及廣州市公共交通網(wǎng)絡(luò)服務(wù)水平,對廣州市公共交通網(wǎng)絡(luò)及醫(yī)院空間布局優(yōu)化提出建議。研究結(jié)論包括:(1)人口老年化趨勢較為明顯的區(qū)域?yàn)橹行某菂^(qū)及城市北部地區(qū);基于廣州市老年人的問卷調(diào)查結(jié)果顯示,老年人就醫(yī)目的地主要為高等級且口碑較好的大醫(yī)院,就醫(yī)出行方式以公交、地鐵為主。(2)對老年人就醫(yī)偏向的各三級醫(yī)院服務(wù)范圍及服務(wù)能力、醫(yī)院服務(wù)質(zhì)量進(jìn)行分析,中心城區(qū)存在部分醫(yī)院服務(wù)域內(nèi)服務(wù)人口較少的現(xiàn)象,服務(wù)范圍內(nèi)服務(wù)人口較多的醫(yī)院主要分布于南沙區(qū)、城市東部的增城及中心城區(qū);城市就醫(yī)評價(jià)數(shù)量空間呈現(xiàn)中心城區(qū)聚集的單中心格局,而醫(yī)院服務(wù)質(zhì)量評價(jià)的空間異質(zhì)性較大。(3)利用綜合交通模型計(jì)算的可達(dá)性結(jié)果顯示老年人就醫(yī)可達(dá)性水平的區(qū)域差異顯著,整體上城市中心區(qū)就醫(yī)可達(dá)性水平整體較高,城市近郊區(qū)大部分地區(qū)可達(dá)性水平較好,其中番禺區(qū)地區(qū)可達(dá)性水平高于北部花都區(qū)等地區(qū);城市遠(yuǎn)郊區(qū)可達(dá)性水平相整體處于較低水平,番禺南部及城市南端的南沙區(qū)可達(dá)性水平較低,城市北端的從化地區(qū)街口街道附近存在相對較好的就醫(yī)可達(dá)性區(qū)域。(4)本研究利用房屋建筑區(qū)面積對醫(yī)院服務(wù)范圍及服務(wù)承載力指數(shù)計(jì)算過程進(jìn)行修正,結(jié)果顯示利用房屋建筑區(qū)面積計(jì)算出的各醫(yī)院服務(wù)域結(jié)果更為精細(xì),區(qū)域差異更小,與實(shí)際情況更加貼近;此外,基于老年人群就醫(yī)特征,改進(jìn)的可達(dá)性模型是一種行之有效的可達(dá)性測度方法,為探索不同人群就醫(yī)時(shí)空可達(dá)性研究提供了新的視角及思路。
[Abstract]:With the acceleration of the aging process, the elderly as a special population has increasingly become the focus of attention in various fields, especially in the medical and health institutions. The service radius of various types of public service facilities, including medical facilities, is usually determined by the travel time taken by the entire population, which can easily lead to the layout of medical facilities exceeding the daily activities of the elderly. Thus affecting the access to health care of the elderly. Based on the above background, this study selects Guangzhou as the research area, takes the elderly as the research object, and probes into the spatial differentiation of the level of accessibility to medical treatment in the city. First of all, from the perspective of demand, the elderly population is defined, and the spatial distribution characteristics of the elderly population and the changes in the number of the elderly population in Guangzhou are understood in combination with the distribution of administrative divisions, and the actual questionnaire survey is carried out. Secondly, from the perspective of supply, the characteristics of spatial distribution of medical institutions, service capacity and quality of medical care in Guangzhou were studied. Then from the point of view of the combination of supply and demand, this paper probes into the matching situation between the medical needs of the elderly and the hospital service ability, combining with the characteristics of the elderly medical needs, and obtains the OD traffic time under the mode of transportation for the elderly patients seeking medical treatment through the Internet map. A comprehensive traffic accessibility measurement model was constructed under various traffic travel modes to further explore the space-time accessibility characteristics of the elderly in Guangzhou to judge the lack of medical care. Finally, according to the level of medical accessibility of the elderly and the service level of Guangzhou public transportation network, the paper puts forward some suggestions on the optimization of the public transport network and hospital spatial layout in Guangzhou. The main conclusions are as follows: (1) the main areas with obvious population aging trend are the central urban area and the northern part of the city, and the results of the questionnaire survey based on the elderly in Guangzhou show that the medical destination of the elderly is mainly high grade large hospitals with good reputation. The main modes of medical travel are public transportation and subway. (2) the service range and service capacity of the elderly hospitals are analyzed, and the quality of hospital service is analyzed. There is a phenomenon that there is a small number of service population in some hospital service areas in the central urban area. The hospitals with large service population are mainly distributed in Nansha district, Zengcheng city and central city area in the eastern part of the city. But the spatial heterogeneity of hospital service quality evaluation is greater. (3) the results of the comprehensive traffic model show that the regional difference of the medical accessibility level of the elderly is significant, and the overall level of access to medical treatment in the urban center is higher. The level of accessibility in most of the near suburbs of the city is higher than that in the northern Huadu district, and the level of accessibility in the far suburbs of the city is at a relatively low level, and the level of accessibility in Panyu district is higher than that in the northern Huadu district. In the south of Panyu and the southern tip of the city, the level of accessibility in Nansha area is low, In the north of the city, there is a relatively good area of access to medical treatment near the street in Conghua district. (4) this study modifies the service range and service carrying capacity index of the hospital by using the area of the building area. The results showed that the results of the hospital service domain calculated by using the area of the building area were more precise, the regional difference was smaller and closer to the actual situation; in addition, based on the characteristics of the elderly people seeking medical treatment, The improved reachability model is an effective method for measuring reachability, which provides a new perspective and train of thought for exploring the spatio-temporal reachability of different populations.
【學(xué)位授予單位】：廣州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：C913.6

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