中国地理科学 ›› 2018, Vol. 28 ›› Issue (2): 353-362.doi: 10.1007/s11769-018-0950-x

• 论文 • 上一篇    

Spatial Differentiation and Influencing Mechanism of Medical Care Accessibility in Beijing: A Migrant Equality Perspective

ZHAO Meifeng1, LIU Shenghe2, QI Wei2   

  1. 1. School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin 300387, China;
    2. Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing 100101, China
  • 收稿日期:2017-05-17 修回日期:2017-09-15 出版日期:2018-04-27 发布日期:2018-02-08
  • 通讯作者: LIU Shenghe.E-mail:liush@igsnrr.ac.cn E-mail:liush@igsnrr.ac.cn
  • 基金资助:

    Under the auspices of National Natural Science Foundation of China (No. 41701151), MOE (Ministry of Education in China) Project of Humanities and Social Sciences (No. 17YJCZH256), Doctoral Project of Tianjin Normal University (No. 52XB1621)

Spatial Differentiation and Influencing Mechanism of Medical Care Accessibility in Beijing: A Migrant Equality Perspective

ZHAO Meifeng1, LIU Shenghe2, QI Wei2   

  1. 1. School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin 300387, China;
    2. Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing 100101, China
  • Received:2017-05-17 Revised:2017-09-15 Online:2018-04-27 Published:2018-02-08
  • Contact: LIU Shenghe.E-mail:liush@igsnrr.ac.cn E-mail:liush@igsnrr.ac.cn
  • Supported by:

    Under the auspices of National Natural Science Foundation of China (No. 41701151), MOE (Ministry of Education in China) Project of Humanities and Social Sciences (No. 17YJCZH256), Doctoral Project of Tianjin Normal University (No. 52XB1621)

摘要:

Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all the people proposed by central government of China. Using the spatial analysis and the statistical analysis, this study evaluates the spatial differentiation of medical care facilities accessibility by constructing STT (Shortest Travel-Time) and SAI (Spatial Accessibility Index). And then this study explores the neighborhood effects on the medical care facilities accessibility in Beijing, with a particular focus on the effect of neighborhood migrant proportion by constructing spatial dependent regression model. The spatial accessibility analysis of medical care facilities show that the spatial distribution of medical care facilities was basically consistent with administrative regions but not with population demands. Bivariate LISA cluster maps identify that suburban areas are the overlapped clusters of high percent of migrants and limited medical care services. This is associated with the public service allocation rule in China, which stresses equality within urban areas and within rural areas but overlooks equality between urban areas and rural areas; and stresses local resident demands but overlooks migrant demands. To estimate the effects on medical care accessibility of neighborhood migrant proportion, spatial dependence models are applied due to spatial dependence of accessibility of medical care facilities. The regression results show that neighborhoods with high percent of migrants, even conditioning on neighborhood SES, are related to limited spatial accessibility of medical care services. Besides neighborhood characteristics, another important factor influencing spatial accessibility of medical care services is the process of spatial spillover effects. This indicates that the attenuate accessibility of medical care services for migrants is not only because of their own constraints but also because of their proximity to other disadvantaged neighborhoods. Therefore, it is urgently needed to increase the medical facilities in the suburban areas, to take into account migrants' demands and to reduce residential segregation between local residents and migrants for local governments to achieve the goal of equalization of medical care service.

关键词: medical care facility, spatial accessibility, migrant equality, influencing mechanism, Beijing

Abstract:

Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all the people proposed by central government of China. Using the spatial analysis and the statistical analysis, this study evaluates the spatial differentiation of medical care facilities accessibility by constructing STT (Shortest Travel-Time) and SAI (Spatial Accessibility Index). And then this study explores the neighborhood effects on the medical care facilities accessibility in Beijing, with a particular focus on the effect of neighborhood migrant proportion by constructing spatial dependent regression model. The spatial accessibility analysis of medical care facilities show that the spatial distribution of medical care facilities was basically consistent with administrative regions but not with population demands. Bivariate LISA cluster maps identify that suburban areas are the overlapped clusters of high percent of migrants and limited medical care services. This is associated with the public service allocation rule in China, which stresses equality within urban areas and within rural areas but overlooks equality between urban areas and rural areas; and stresses local resident demands but overlooks migrant demands. To estimate the effects on medical care accessibility of neighborhood migrant proportion, spatial dependence models are applied due to spatial dependence of accessibility of medical care facilities. The regression results show that neighborhoods with high percent of migrants, even conditioning on neighborhood SES, are related to limited spatial accessibility of medical care services. Besides neighborhood characteristics, another important factor influencing spatial accessibility of medical care services is the process of spatial spillover effects. This indicates that the attenuate accessibility of medical care services for migrants is not only because of their own constraints but also because of their proximity to other disadvantaged neighborhoods. Therefore, it is urgently needed to increase the medical facilities in the suburban areas, to take into account migrants' demands and to reduce residential segregation between local residents and migrants for local governments to achieve the goal of equalization of medical care service.

Key words: medical care facility, spatial accessibility, migrant equality, influencing mechanism, Beijing