Spatial Location -allocation Optimization for Rural Hospital with A Improved Regional Allocation Model: A Case Study in Xiantao City of Hubei Province
Lei Luo, Jing Luo, Lingling Tian, Pengcheng Liu, Wensheng Zheng
SCIENTIA GEOGRAPHICA SINICA ›› 2016, Vol. 36 ›› Issue (4) : 530-539.
Spatial Location -allocation Optimization for Rural Hospital with A Improved Regional Allocation Model: A Case Study in Xiantao City of Hubei Province
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.
Fig.1 Running results of the traditional allocation model图1 传统区位配置模型运行结果 |
Table 1 The result comparison of traditional location-allocation model表1 传统区位配置模型运行结果对比 |
模型 | 覆盖居民点数 | 满足需求 | 加权总成本 | ||
---|---|---|---|---|---|
最小化设施点 | 645个 | (99.85%) | 2750212次 | (99.85%) | 5950787 |
最小化阻抗 | 645个 | (99.85%) | 2750212次 | (99.85%) | 3343426 |
最大化覆盖 | 646个 | (100%) | 2754068次 | (100%) | 3364990 |
最大化有容量限制覆盖 | 425个 | (65.78%) | 2024543次 | (73.51%) | 3591215 |
Table 2 Hospital rating scale evaluation system |
指标归类 | 变量 | 指标(人) | 指标归类 | 变量 | 指标 |
---|---|---|---|---|---|
医疗服务人员 | X1 X2 X3 X4 X5 X6 X7 | 执业医师 执业助理医师 注册护士 药剂师 检验技师 影像技师 其他卫技人员 | 医疗机构设备 医疗机构资产 医院诊疗能力 | X8 X9 X10 X11 X12 X13 X14 | 管理人员(人) 实有床位数(床) 设备总台数(台) 万元以上设备(台) 房屋建筑总面积(m2) 总诊疗人次(人) 出院人次(人) |
Table 3 Scale grade evaluation of hospital表3 医院规模等级评价 |
医院名称 | F | wj | 医院名称 | F | wj | 医院名称 | F | wj |
---|---|---|---|---|---|---|---|---|
第一人民医院 | 63887 | 3 | 张沟中心卫生院 | 7735 | 2 | 复兴卫生院 | 3002 | 2 |
中医医院 | 16707 | 3 | 胡场镇卫生院 | 7523 | 2 | 江汉医院 | 2166 | 1 |
三伏潭镇卫生院 | 14805 | 3 | 长埫口中心卫生院 | 7451 | 2 | 工业园社区 | 2008 | 1 |
陈场镇卫生院 | 12271 | 3 | 沔城回族镇卫生院 | 6923 | 2 | 姚咀仁和医院 | 1641 | 1 |
毛嘴中心卫生院 | 11735 | 3 | 新里仁口卫生院 | 6388 | 2 | 优抚医院 | 1580 | 1 |
郭河镇卫生院 | 11072 | 3 | 同泰医院 | 6326 | 2 | 职业学院附属医院 | 1280 | 1 |
博爱医院 | 10243 | 3 | 沙湖中心卫生院 | 6271 | 2 | 埫口镇大福医院 | 1202 | 1 |
剅河镇卫生院 | 9771 | 2 | 西流河中心卫生院 | 6200 | 2 | 干河社区 | 1187 | 1 |
杨林尾镇卫生院 | 9700 | 2 | 下查埠医院 | 5028 | 2 | 仁爱医院 | 945 | 1 |
郑场镇卫生院 | 9217 | 2 | 袁市卫生院 | 4016 | 2 | 沙嘴社区 | 838 | 1 |
第二人民医院 | 9098 | 2 | 剅河镇谢场卫生院 | 3523 | 2 | 龙华山社区 | 752 | 1 |
第三人民医院 | 8925 | 2 | 第四人民医院 | 3327 | 2 | |||
通海口中心卫生院 | 8577 | 2 | 敦厚医院 | 3105 | 2 |
Fig.2 Running results of improved regional allocation model图2 改进区位配置模型运行结果 |
Table 4 Each time period to obtain the medical needs (before adjustment scale)表4 各时间段居民点获得医疗需求次数统计(调整规模前) |
就医所需时间(min) | 覆盖居民点数百分比 | 满足医疗需求次数(次) | 满足需求次数百分比 |
---|---|---|---|
0~15 15~30 30~60 总结 | 48.57% 32.46% 17.13% 98.16% | 1654644 681081 365189 2701189 | 60.08% 24.73% 13.26% 98.08% |
医院名称 | 现有床位 数(床) | 现有医务 人员(人) | 实际服务 人口(人) | 理论服务 人口(床) | 需增加床 位数(床) | 规划增加 床位(床) | 理论服务 人口(人) | 需增加医务人员 | 规划增加医务人员(人) |
---|---|---|---|---|---|---|---|---|---|
第一人民医院 | 1040 | 1549 | 581642 | 393939 | 496 | 496 | 415504 | 619 | 619 |
中医医院 | 471 | 675 | 293458 | 178409 | 304 | 304 | 181062 | 419 | 419 |
第三人民医院 | 350 | 241 | 180910 | 132576 | 128 | 128 | 64646 | 433 | 433 |
工业园社区 | 20 | 35 | 18900 | 7576 | 30 | 30 | 9388 | 35 | 35 |
龙华山社区 | 15 | 27 | 7143 | 5682 | 4 | 4 | 7242 | 0 | 0 |
同泰医院 | 60 | 91 | 60827 | 22727 | 101 | 101 | 24410 | 136 | 136 |
江汉医院 | 99 | 77 | 88608 | 37500 | 135 | 135 | 20655 | 253 | 253 |
仁爱医院 | 80 | 59 | 8149 | 30303 | -58 | 0 | 15826 | -28 | 0 |
职业学院附属医院 | 110 | 149 | 10056 | 41667 | -83 | 0 | 39968 | -111 | 0 |
第四人民医院 | 158 | 153 | 30142 | 59848 | -78 | 0 | 41041 | -41 | 0 |
三伏潭镇卫生院 | 80 | 114 | 41006 | 30303 | 28 | 28 | 30579 | 39 | 39 |
毛嘴中心卫生院 | 60 | 110 | 33150 | 22727 | 28 | 27 | 29506 | 14 | 14 |
新里仁口卫生院 | 20 | 41 | 18172 | 7576 | 28 | 27 | 10998 | 27 | 27 |
剅河镇卫生院 | 44 | 97 | 25731 | 16667 | 24 | 23 | 26019 | -1 | 0 |
陈场镇卫生院 | 70 | 112 | 33734 | 26515 | 19 | 19 | 30043 | 14 | 14 |
郑场镇卫生院 | 50 | 78 | 24325 | 18939 | 14 | 14 | 20923 | 13 | 13 |
下查埠医院 | 22 | 35 | 13366 | 8333 | 13 | 13 | 9388 | 15 | 15 |
复兴卫生院 | 20 | 19 | 8555 | 7576 | 3 | 2 | 5097 | 13 | 13 |
通海口中心卫生院 | 80 | 124 | 24840 | 30303 | -14 | 0 | 33262 | -31 | 0 |
沙湖中心卫生院 | 70 | 86 | 16588 | 26515 | -26 | 0 | 23069 | -24 | 0 |
长埫口中心卫生院 | 60 | 104 | 19754 | 22727 | -8 | 0 | 27897 | -30 | 0 |
张沟中心卫生院 | 88 | 93 | 21176 | 33333 | -32 | 0 | 24946 | -14 | 0 |
西流河中心卫生院 | 50 | 112 | 16225 | 18939 | -7 | 0 | 30043 | -52 | 0 |
胡场镇卫生院 | 69 | 89 | 22282 | 26136 | -10 | 0 | 23873 | -6 | 0 |
沔城回族镇卫生院 | 65 | 78 | 21285 | 24621 | -9 | 0 | 20923 | 1 | 1 |
郭河镇卫生院 | 85 | 85 | 30488 | 32197 | -5 | 0 | 22800 | 29 | 29 |
第二人民医院 | 90 | 75 | 23981 | 34091 | -27 | 0 | 20118 | 14 | 14 |
杨林尾镇卫生院 | 75 | 102 | 26378 | 28409 | -5 | 0 | 27361 | -4 | 0 |
敦厚医院 | 30 | 39 | 8626 | 11364 | -7 | 0 | 10461 | -7 | 0 |
大福医院 | 38 | 36 | 5725 | 14394 | -23 | 0 | 9657 | -15 | 0 |
谢场卫生院 | 28 | 35 | 10065 | 10606 | -1 | 0 | 9388 | 3 | 3 |
Fig.3 Running results of improved regional allocation model (after adjustment scale)图3 改进区位配置模型调整结果 |
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The authors have declared that no competing interests exist.
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