中国儿童肿瘤医疗资源供给水平空间特征及影响因素

doi:10.13249/j.cnki.sgs.2023.08.004

Abstract

Abstract:

Malignant tumor is one of the most prevalent diseases threatening the lives of children and adolescents. Access to specialist medical resources is conducive to accurate diagnosis and treatment, significantly improving their cure rates, and optimizing the allocation of healthcare resources can enhance the accessibility of medical services for children with cancer. Thus, this paper reviews the research progress of spatial allocation of health care resources and contributing factors. As a major research subject in health geography, the study of health care resource allocation has focused on public health care resources mainly, but not enough attention has been paid to specific diseases, particularly pediatric oncology health care resources. Based on the data of pediatric surveillance sites, certified hospitals, number of discharged children with cancer of different disease types and children with cancer mobility, this paper used nuclear density, standard deviation ellipse, spatial autocorrelation and coefficient of variation to analyze the spatial pattern of Chinese pediatric cancer healthcare resources, geographic detector are used to explore the influencing factor of spatial pattern of pediatric cancer healthcare resources. Last but not least, policies to optimize the spatial allocation of medical resources for pediatric oncology are summarized. The results have indicated that: 1) There are more pediatric cancer healthcare resources in eastern region than in western region of China, which significantly concentrate in Beijing-Tianjin-Hebei, The Yangtze River Delta and Pearl River Delta region, especially centered in provincial capitals and municipalities. Focusing on the provincial scale, medical resources for pediatric oncology are concentrated in the provincial capitals, while the rest of the cities are less distributed. Medical resources for children with solid tumor are more concentrated in a few large cities than for leukemia and lymphoma, which has led to a large scale medical treatment flows for children with cancer, concentrated in provincial capitals and municipalities, such as Beijing, Jiangsu, Shanghai, Guangdong, Chongqing and Shanxi. 2) The spatial allocation of pediatric cancer healthcare resources is closely related to regional socio-economic development, especially the per capita disposable income, education level, GDP per capita and urbanization rate, while the size distribution of children and the medical insurance are not significant, which is not consistent with other factors influencing the spatial allocation of public health care resources. There is a mismatch between the spatial allocation of medical resources for pediatric oncology and children's needs, and the existing health insurance coverage for pediatric oncology as a specific disease is not sufficient. It is recommended to enhance the treatment capacity of pediatric oncology surveillance sites, promote the secondary medical centers for rare pediatric cancer, and strengthen medical insurance and social support to reduce the treatment burden of children with cancer and their families.

Key words: pediatric cancer, healthcare resources, regional disparity, China

CLC Number:

R197.1

Li Xuelian, Du Fangjuan, Xie Xiao, Li Jiahong, Wu Hanyan. Spatial characteristics and influencing factors of pediatric cancer healthcare resources supply in China[J].SCIENTIA GEOGRAPHICA SINICA, 2023, 43(8): 1350-1359.

Figures/Tables 7

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Table 1

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References 33

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探测指标	x₁	x₂	x₃	x₄	x₅	x₆	x₇	x₈
注：^*、^表示0.05、0.1的显著水平； x₁为儿童规模； x₂为城镇化水平； x₃为人均GDP；x₄为非农产业占比；x₅为人均一般公共预算卫生建康支出；x₆为收入水平； x₇为教育水平；x₈为医疗保障水平；不含港澳台数据。
$ q $ 值	0.06	0.38^*	0.31^*	0.19	0.24	0.58^**	0.57^**	0.08

交互因子	$ q $ 值	交互因子	$ q $ 值	交互因子	$ q $ 值	交互因子	$ q $ 值
注： x₁为儿童规模； x₂为城镇化水平； x₃为人均GDP；x₄为非农产业占比；x₅为人均一般公共预算卫生建康支出；x₆为收入水平； x₇为教育水平；x₈为医疗保障水平；不含港澳台数据。
x₁∩x₂	0.40	x₂∩x₃	0.40	x₃∩ x₅	0.59	x₄∩x₈	0.39
x₁∩x₃	0.40	x₂∩x₄	0.40	x₃∩x₆	0.59	x₅∩x₆	0.59
x₁∩x₄	0.40	x₂∩ x₅	0.60	x₃∩x₇	0.59	x₅∩x₇	0.59
x₁∩x₅	0.28	x₂∩x₆	0.59	x₃∩x₈	0.59	x₅∩x₈	0.59
x₁∩x₆	0.60	x₂∩x₇	0.59	x₄∩x₅	0.59	x₆∩x₇	0.59
x₁∩x₇	0.59	x₂∩x₈	0.60	x₄∩ $ {x}_{6} $	0.59	x₆∩x₈	0.60
x₁∩x₈	0.21	x₃∩x₄	0.34	x₄∩x₇	0.59	x₇∩x₈	0.59

Spatial characteristics and influencing factors of pediatric cancer healthcare resources supply in China

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