关键词: 农村公共医疗服务, 等级规模偏好系数, 改进区位配置模型, 优化布局

Abstract:

With the acceleration of urbanization in China, a large number of rural people have shifted towards into urban area. With the number of local people decreasing in recent years, the result has influenced the problem on how to spatially arrange public basic service facilities in rural area. The centralized layout, expanded size, service quality improved for the public services is the common phenomenon in rural area by merger of village and by abolishing village government. However, with the limitation on the resources, the expanding for each facility lead to the number of facilities decreased, serving radius of facilities increased, and their accessibility lowered. The study on that “how-to” in a scientific and reasonable way provides an effective way for solving the contradiction between quality and accessibility. The spatial arrangement of public health facilities is the key component of the study on the equalization of public services. Therefore the study on their spatial optimization has been paid more and more attention in research fields, such as human geography, medicine, public health and sociology. Taking Xiantao City in Hubei Province as a survey region, we analyzed the spatial optimization of medical services in rural area. The attributes from economy and the natural geography shows homogeneity in our survey region with the typicality in the Jianghan Plain, which is easy to further our research and construct model.

Firstly, according to traditional location-allocation model, based on medical demand preference questionnaire from rural residents and rank-size index evaluation system, the medical behavior preference coefficient from residents, namely the rank-size preference coefficient is built, which is introduced to traditional location configuration model to establish the improved location-allocation model. Secondly, with the integration of GIS network analysis, linear programming modeling tools PuLP and linear programming software Cplex, this article optimizes geographic visualization layout results by using programming language Python to achieve the improved location in ArcGIS10.2 configuration model building, model solvers and rural medical facilities in ArcGIS10.2 Geoprocessing framework. Finally, the experiments by optimizing the size and number of medical facilities in rural areas can significantly reduce the cost of resident medical space, meet more medical needs, improve utilization and coverage of medical resources, and also verify the practicality and effectiveness of the secondary development tools. The results show that: the spatial arrangement of medical service after adjustment is more reasonable, which represents the spatial cost from the settlement to medical service facilities decreased. The experiment shows that the more medical service is fulfilled in 15 minutes, which enhance the efficiency and also reduce the time cost for local people seeking medical advice. The improved regional-allocation model provides an effective way for answer that “how-to” question. Therefore, the model has a universal function which can be applied to location-selecting problem for other public service facilities. In practical application, the model can be adjusted according to demands and circumstances. The model construction and simulation methods in our study are suitable for spatial optimization of medical facilities arrangement in rural area in plain region. Moreover, it provides the reference to the spatial optimization of medical facilities arrangement, especially of county-level which is of complex terrain and road network structure.

Key words: public medical service in rural areas, rank-size preference coefficient, improved regional allocation model, optimistic rxperiment