scholarly journals Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China

2020 ◽  
Vol 18 (1) ◽  
pp. 112
Author(s):  
Kan Wang ◽  
Jianjun Bai ◽  
Xing Dang
Keyword(s):  
Medical Treatment ◽  
Public Transportation ◽  
Supply And Demand ◽  
Research Area ◽  
Space Time ◽  
Shaanxi Province ◽  
Medical Services ◽  
Chinese Government ◽  
Medical Facilities ◽  
Spatial Differences

The contradiction between the supply and demand of public medical resources in China is serious. On the basis of the “graded diagnosis and treatment” model, the Chinese government divides the medical grade and adjusts the allocation of medical facilities so as to alleviate the adverse impact of these issues on residents’ health. Although the government tries to guide residents’ medical treatment according to the level of medical facilities, there are differences between residents’ medical treatment mode and policy rules in reality. Therefore, it is of great significance to explore spatial differences in accessibility to medical services for residents on the basis of the actual medical behavior. This article takes Shaanxi province as the research area, and uses the improved node cost network analysis method with the space-time distance model and the two-step floating catchment area method, respectively, to analyze the spatial differences of accessibility to three-level medical services and evaluate the equity of accessibility in different areas and groups in Shaanxi. Results showed that the overall level of accessibility to primary medical services in the province is good, and spatial distribution is balanced; the polarization of accessibility to secondary and tertiary medical services is a serious issue, and within the research area, a band-shaped multicore spatial structure was formed with the built-up areas of various cities as high-level centers of accessibility. Provincial residents have poor equity to access three-level medical services, and the equity of accessibility to primary medical services is better than that to highly specialized medical services. There is no obvious gap between accessibility to three-level medical services for the aging and the nonaging populations in Shaanxi, but the unfair phenomenon between agricultural and the nonagricultural populations is prominent. In addition, this article found that the improvement in traffic conditions can produce space-time convergence and effectively weaken spatial deprivation. Therefore, developing public transportation is an effective approach to improve the equity of accessibility to medical services.

scholarly journals Public Transportation Environment and Medical Choice for Chronic Disease: A Case Study of Gaoyou, China

2019 ◽  
Vol 16 (9) ◽  
pp. 1612
Author(s):  
Yang Cao ◽  
Feng Zhen ◽  
Hao Wu
Keyword(s):  
Built Environment ◽  
Low Income ◽  
Patient Preferences ◽  
Public Transportation ◽  
Supply And Demand ◽  
Socioeconomic Background ◽  
Medical Facilities ◽  
Patient Questionnaires ◽  
Medical Choice ◽  
The Impact

Current research on the built environment and medical choice focuses mainly on the construction and optimization of medical service systems from the perspective of supply. There is a lack of in-depth research on medical choice from the perspective of patient demand. Based on the medical choice behaviour of patients with chronic diseases, this article identifies the spatial distribution and heterogeneity characteristics of medical choice and evaluates the balance between medical supply and demand in each block. On this basis, we explored the mechanism of patient preferences for different levels of medical facilities by considering the patient’s socioeconomic background, medical resource evaluation, and other built environment features of the neighbourhood by referring to patient questionnaires. In addition to socioeconomic characteristics, the results show that public transportation convenience, medical accessibility, and medical institution conditions also have significant influences on patient preferences, and the impact on low-income patients is more remarkable. The conclusions of the study provide a reference for the promotion and optimization of the functions of urban medical resources and the guidance of relevant public health policies.

scholarly journals Inequality and Influencing Factors of Spatial Accessibility of Medical Facilities in Rural Areas of China: A Case Study of Henan Province

2019 ◽  
Vol 16 (10) ◽  
pp. 1833 ◽  
Author(s):  
Shirui Liu ◽  
Yaochen Qin ◽  
Yanan Xu
Keyword(s):  
Influencing Factors ◽  
Rural Areas ◽  
Henan Province ◽  
Spatial Accessibility ◽  
Medical Services ◽  
Basic Unit ◽  
Mountainous Areas ◽  
Geographically Weighted Regression Model ◽  
Medical Facilities ◽  
Spatial Differences

The equalization of medical services has received increasing attention, and improving the accessibility of medical facilities in rural areas is key for the realization of fairness with regard to medical services. This study studies the rural areas of Henan Province, China, and uses unincorporated villages as the basic unit. The spatial pattern of accessibility in rural areas was comprehensively analyzed via geographic information system spatial analysis and coefficient of variation. The spatial heterogeneity of relevant influencing factors was assessed by using the geographically weighted regression model. The results show that: (1) The distance cost of medical treatment in rural areas is normally distributed, and most areas are within a range of 2–6 km. (2) The accessibility in rural areas has clear spatial differences, is significantly affected by terrain, and shows characteristics of significant spatial agglomeration. The eastern and central regions have good spatial accessibility, while the western regions have poor spatial accessibility. Furthermore, regions with poor accessibility are mainly located in mountainous areas. (3) The spatial equilibrium of accessibility follows a pattern of gradual deterioration from east to west. The better accessibility-unbalanced type is mostly located in the center of Henan Province, while the poor accessibility-unbalanced type is concentrated in mountainous areas. (4) The area, elevation, residential density, and per capita industrial output are positively correlated with spatial accessibility, while road network density and population density are negatively correlated.

scholarly journals Supply-Demand Matching of Medical Services in Haikou Under the Background of Hierarchical Diagnosis and Treatment - Based on Didi Travel Data

2021 ◽  
Author(s):  
Haiyan Shao ◽  
Cheng Jin ◽  
Jing Xu ◽  
Yexi Zhong ◽  
Bing Xu
Keyword(s):  
Medical Treatment ◽  
Supply And Demand ◽  
Diagnosis And Treatment ◽  
Medical Services ◽  
Density Data ◽  
Demand Pattern ◽  
Medical Institutions ◽  
Accessibility Pattern ◽  
High Level ◽  
Different Levels

Abstract Background Implementation of the Healthy China Strategy and the hierarchical diagnosis and treatment system has injected new vitality into medical services. Given the insufficient supply of medical services and increasing demand for medical treatment, exploring the supply-demand pattern of medical services has become an urgent theoretical and practical problem to be solved. The equity of healthcare facilities has received widespread attention, but due to limited data, there is little research on the supply-demand pattern of medical services. This study focuses on evaluating the supply-demand matching pattern of medical services at different levels in Haikou City with big geographic data and promoting the realization of a balance between medical supply and demand. Methods This study utilizes spatial data of medical institutions, didi travel data, and population density data. Firstly, use the two-step floating catchment area method and GIS spatial analysis to explore characteristics of the supply-demand patterns of medical services at different levels in Haikou. Secondly, based on didi travel data, mine residents' demand for medical treatment. Then combined with population density data, divide supply-demand matching of medical institutions into four types. Finally, propose optimization strategies for the problems. Results The accessibility pattern of high-level medical institutions in Haikou presents high in the north and low in the south. The accessibility pattern of low-level medical institutions is the opposite. High-level medical institutions have a strong need for medical treatment, which is less hampered by distance. The healthcare demand of low-level medical institutions is small, and they mainly are medium- and short-distance medical travel. The types of medical services at different levels are mainly "low supply - low demand" and "high supply - low demand" types. Conclusions Medical services at different levels in Haikou are mainly in supply-demand imbalance. Therefore, we put forward optimization strategies to promote the equity of primary medical services, such as propelling the establishment and improvement of the hierarchical diagnosis and treatment system, building a new model of medical and health service supply, and strengthening balanced coverage of primary medical institutions. The mining of big geographic data is beneficial to alleviate the contradiction between medical supply and demand, although the data and methods need to be improved.

scholarly journals Health City and Fair Treatment: Medical Treatment Behaviour of the Elderly Population in Shanghai

2020 ◽  
Author(s):  
Shangguang YANG ◽  
Danyang WANG ◽  
Chen Li ◽  
Chunlan Wang ◽  
Mark Wang
Keyword(s):  
Medical Treatment ◽  
Elderly Population ◽  
Personal Information ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Medical Services ◽  
Social Characteristics ◽  
Chinese Government ◽  
Medical Needs ◽  
Price Demand

Abstract Background: Issues related to the satisfaction of the elderly population towards health and medical services have become an increasing social concern in China, under the influence of individuals, medical institutions and social factors, the structural contradictions of the elderly population’s demand in terms of medical and health services are very prominent. This study seeks to assist in the resolution of issues faced by the elderly when dealing with their medical needs and improve the quality of medical services in megacities in China.Methods: This study analyses the difference in behaviour of the elderly towards medical treatment in Shanghai based on 625 questionnaires. The investigation mainly includes five parts: personal information, health status, elderly person’s medical preference and expectation, satisfaction towards hospitals and medical services, and medical insurance mode and the level of success from use. The study uses Multinomial logistic regression to investigate the influencing factors.Results: To the elderly group in Shanghai, their medical treatment behaviors based on rational choices around price, demand and supply of medical services. The stratification of medical services based on the economic and social characteristics of the elderly population is obvious. Overall, our results show that, firstly, factors such as age, marriage status, relationship, residential location and medical treatment distance have great impacts on the elderly population’s medical treatment choices. Secondly, Chinese elderly people rely heavily on family support. Thirdly, medical treatment behaviour has a distance friction effect: the closer to hospital, the stronger the tendency to choose. Fourthly, Shanghai and other big Chinese cities are in the stage of population suburbanization, but the allocation of public service resources, such as medical, health and education, still presents a strong centripetal agglomeration in space.Conclusions: The study further contributes to public resource distribution and justice between different groups of people in the context of social stratification. while strengthening the reform of medical marketization and improving the efficiency of supply of scarce medical products, the Chinese government should also strengthen the reform of system design and strengthen the total supply and structural balance of geriatric care, especially the weak geriatric products.

scholarly journals Analysis of cases managed by dermatological service in the Chinese peacekeeping level 1+ medical treatment facility in Lebanon, 2018–2019

2020 ◽  
pp. jramc-2019-001315
Author(s):  
Xingwang Wang ◽  
H Yang ◽  
Yuqing Wang ◽  
Jin Yuan ◽  
Qinghua Yu
Keyword(s):  
Medical Treatment ◽  
Skin Diseases ◽  
Acne Vulgaris ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Common Category ◽  
Medical Facilities ◽  
Different Types ◽  
Level 1 ◽  
Basic Medical

IntroductionTo accomplish the peacekeeping mission in Lebanon, China has deployed a level 1+ (CHN L1+) medical treatment facility (MTF) as per the new memorandum. The aim of this study was to review and analyse the skin diseases managed by Chinese dermatological service so as to gain the latest prevalence of different types of skin diseases in this mission area.MethodsAll patients assessed and treated by the dermatological service of CHN L1+ MTF from January 2018 to May 2019 were included. A comparative analysis was made between this study and data published by other peacekeeping medical facilities.ResultsA total of 549 patients were included (87.4% men, with an average age of 35 years old), consisting of 399 military personnel and 150 civilians. Dermatitis and eczema (27.1%) were the most common category of skin diseases, followed by cutaneous mycoses (13.3%) and disorders of skin appendages (10.6%). Among these categories, unspecified dermatitis (9.3%), acne vulgaris (6.6%), tinea corporis (5.3%), folliculitis (5.1%) and tinea pedis (4.7%) were the top five most common reasons for dermatological consultation.ConclusionsTo get a clearer understanding of the disease-type profile in this mission area was beneficial for peacekeeping doctors to make more accurate diagnosis, as well as to prepare more comprehensive medicines during the predeployment period. As dermatological service was lacking in basic medical troops, we would recommend the use of telemedicine to promote dermatological consultations when a specialist was not deployed.

Life and Limb

2016 ◽  
Keyword(s):  
Civil War ◽  
Medical Treatment ◽  
American Civil War ◽  
Related Material ◽  
Critical Studies ◽  
Medical Facilities ◽  
Private And Public

This volume assembles selections from writings on the American Civil War in fiction, first-hand accounts and contemporary reportage, all supplemented with photographs. The focus falls on the injuries sustained by participants and on their medical treatment. Writers and poets are included who drew on their experiences as nurses, combatants or observers. The volume focuses thematically on nursing, medical facilities, photography, amputations, battlefield accounts, and the war’s aftermath. The excerpts are supplemented by critical studies by specialists in the different aspects of the Civil War. Each excerpt is introduced by brief editorial commentaries, guiding the reader towards further related material and an overall introduction to the volume addresses the blurring between private and public documents as well as the different methods of recording these events.

Correlation of age and rurality with low-urgency use of emergency medical services (LUEMS): A geographic analysis

CJEM ◽  
2017 ◽  
Vol 20 (6) ◽  
pp. 874-881 ◽  
Author(s):  
Mikiko Terashima ◽  
Alix J.E. Carter
Keyword(s):  
Emergency Medical Services ◽  
Public Transportation ◽  
Rural Areas ◽  
Tertiary Care ◽  
Incidence Rates ◽  
Medical Services ◽  
Older Population ◽  
Age Cohorts ◽  
Geographic Analysis ◽  
Emergency Medical

ABSTRACTObjectivesStudies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis.MethodsRecords with Canadian Triage and Acuity Scale of 4 and 5 were considered as LUEMS. We assessed the distribution of LUEMS incidence rates (proportion of LUEMS out of all EMS uses) by age and rurality, using descriptive statistics and Geographic Information Systems mapping.ResultsNearly half of all EMS transports were individuals of 65+ years of age; 35% of those were LUEMS. The rates increased along with the level of rurality, and the older cohort had the highest incidence rates in non-metro communities. High rates were seen primarily in some rural communities farthest away from the capital/tertiary care centre.ConclusionHigh LUEMS incidence rates are rural phenomena but not specific to the older population. However, the absolute number of LUEMS by the older cohort is significant, and elder-specific interventions in rural regions could still lead to effective cost savings. Further investigation of other factors, such as distance to the emergency department, availability of public transportation, and socioeconomic conditions of EMS users, is needed.

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