共查询到20条相似文献，搜索用时 31 毫秒
1.
Long distances and sparse service networks set challenging conditions for material logistics in health care. Globally, health care organisations have been making structural changes towards centralised warehousing and deliveries. In Northern Finland, material logistics of the public health care system rely mainly on numerous separate order and delivery systems, although logistics needs, ordering and stock in different health care facilities correspond to each other. As centralised logistics in orders and deliveries may lead to remarkable savings, pressure for centralised management is high. This paper analyses how effectively a potential centralised warehousing system can be organised based on its spatial components. These include optimal location of one or more warehouses, delivery network coverage and efficiency of routes, as well as accessibility of health centres and hospitals. The geographic information systems (GIS) -based accessibility analytical framework described in this study applies vehicle routing and heuristic computations to location-allocation of warehouses to potential sites by optimising transport cost with a constraint to provide service to at least 90% of delivery demand. The spatial data include the road network, health care facility locations with rough estimates of freight demand nodes and potential locations of warehouse facilities. The main findings of the study show that majority of health centres and hospitals can be effectively reached by a delivery network based on one or two warehouses. Furthermore, the efficiency of the delivery network does not increase remarkably by increasing the number of warehouses, when measured as driving time. 相似文献
2.
Lasse Møller-Jensen Richard Y. Kofie 《Geografisk tidskrift / udgivet af Bestyrelsen for Det Kongelige danske geografiske selskab》2013,113(1):145-153
The preconditions for applying GIS-based location-allocation analysis for health service planning in rural Ghana are examined in terms of data availability and quality. A population map is established from the latest available census using geo-coding methods and digital topographic sheets. A vector-based transport model of the region is established by merging data from several sources including GPS. It is suggested that a hybrid transport model is required. This model combines the possibilities for all-direction transportation inherent in the raster-based approach with the possibilities for road/path transportation inherent in the vector-based approach. All-direction movements are expected to take place close to the villages in order to reach a suitable linear transport corridor represented by a vector. Several scenarios for improving the accessibility aspects of the health service provision are examined in light of Ghana's current health service policy. Location-allocation modelling tools are used to select optimal locations and provide statistics on average distance to health centres and percentage of population covered. 相似文献
3.
The classical geographic research problem of regionalization and resource allocation is most commonly tackled by means of location-allocation methods. This paper introduces the spatial-order method as an alternative for creating regions or clusters. The spatial-order method utilizes space-filling curves, also known as Peano curves, to determine the nearness or spatial order of areal units, such as counties. Given a capacity constraint, the areal units are grouped consecutively according to their spatial order values. We applied the method to create clusters of rural counties for a national sampling survey of HIV/AIDS patients in the United States. Using the criteria that each cluster had approximately 50 new AIDS cases in 1991–1993 and that contiguity of areal units was maximized, 226 clusters were created from the 1,853 rural counties or health districts. The rural clusters generated by this method have been adopted as the national rural sampling frame in the HIV Cost and Services Utilization Study (HCSUS) being undertaken by RAND. In addition to its simplicity and fast computational speed, the spatial-order method produces satisfactory results. With minor modifications, this method can be an efficient alternative to the location-allocation method for solving a wide variety of locational problems, such as routing, political districting, and facilities location and allocation. This paper also demonstrates how a classical geographic research methodology, with the enhancement of GIS, can contribute to the multidisciplinary study of a pressing societal problem in our nation. 相似文献
4.
基于潜能模型的医疗设施空间可达性评价方法 总被引：15，自引：4，他引：11
空间可达性是评价医疗设施布局合理与否的重要指标,传统的医疗设施空间可达性评价,或者从医疗服务供需状况着手,或者从供需双方之间距离因素着手,均无法全面评价居民实际所能获取的医疗资源。本文采用基于潜能模型的评价方法对江苏省如东县医疗设施空间可达性进行分析研究,该方法综合考虑了医疗设施服务能力、居民点人口数量、医疗设施与居民点之间的出行阻抗。研究表明,通过选取合适的出行摩擦系数,该方法能够较为全面准确地测度较小研究单元的医疗设施空间可达性,辅以GIS技术,可以很直观地揭示研究区域内医疗设施空间可达性差异,结合公共卫生管理部门制定的医疗资源配置标准,还可较为准确判定缺医地区,为政府相关部门规划决策提供依据。 相似文献
5.
Abstract: Public health planners should be providing evidence to the public that maternity units are fairly distributed. This research demonstrates how a Geographical Information System (GIS) can be used to provide information on travel time to the closest maternity unit from the 38 000 population census enumeration districts in New Zealand. The distribution of accessibility is mapped and regions and population groups that appear under-serviced are highlighted. We conclude by stating that GIS accessibility models provide important evidence for health policy and that the information generated from these models should be routinely produced for a wide range of health services and communicated to the public. 相似文献
6.
7.
儿童服务设施是建设儿童友好性城市的重要内容。基于北京城区社区人口数据及儿童服务设施数据,通过两步移动搜寻法,以社区为单元分析儿童服务设施可达性的空间格局及分布模式。结果显示,不同类别儿童服务设施空间可达性服务水平差异较大,在1000米阈值范围内小学的空间可达性水平优于幼儿园,3000米阈值范围内儿童诊所的空间可达性优于公园。受儿童人口和儿童服务设施分布的影响,小学、幼儿园、儿科门诊的可达性均呈现“中心高、边缘低”的分布格局,空间分布不均衡;公园分布则相对分散,其可达性呈现边缘区域优于中心区域分布特征。北京城区儿童服务设施可达性情况可分为五种类型区,类型区之间以同心圆的结构进行组合,局部体现出扇形的特征。据此提出针对不同区域儿童服务设施的改善策略。 相似文献
8.
Cardiovascular diseases (CVDs) are a leading cause of mortality in the US. Rates of mortality vary spatially and demographically, influenced not only by individual patient characteristics but also by levels of accessibility to hospital services and facilities. In 2000, Kentucky ranked third in the nation for heart-related deaths. The purpose of this paper is to assess geographical accessibility and service utilization related to ambulatory care sensitive CVDs in Kentucky. This study utilizes the Kentucky Hospital Discharge Database to evaluate service utilization and the Compressed Mortality File to examine mortality related to CVDs. A spatial statistical comparison of the geographical distribution of service usage and travel time to hospitals assists in assessing the relationship between accessibility and health. Our findings suggest that the distribution of utilization and mortality is geographically variable. People living in rural areas travel further to services; populations residing more than 45 min from health facilities are more likely to be socially and economically marginalized. Spatial clustering of high rates of hospital utilization occurs in areas with lower accessibility. 相似文献
9.
建成环境对公共健康的影响路径仍藏于黑箱中,且既有片段式分析多未考虑居住自选择问题。基于福州市社会调查,建构结构方程模型。研究发现：通过体力活动的中介作用,密度及多样性、道路通达性、形象维护管理、体育设施可达性均与生理健康自评值存在正向关联;前三类建成环境特征主要经由社会资本、犯罪活动、居住安全感对休闲型步行产生间接正向效应,中高强度体力活动则受到实体要素直接影响;通过饮食行为的中介作用,提高健康食物可达性能有效减少罹患慢性病的种类数。即使规避了自选择干扰,上述建成环境特征依然对生理健康状况具有显著影响,证明建成环境优化确是改善公共健康的可行途径,需在城市规划中兼顾体育和食物环境两项重点、硬件和软件环境两个层面。 相似文献
10.
Prince Michael Amegbor 《Norsk geografisk tidsskrift. Norwegian journal of geography》2017,71(5):288-300
Studies of health care and health-care seeking behaviour in Ghana have mainly shown that many patients tend to use indigenous medicine to address their health care needs. These studies have cited affordability, acceptability, availability, and accessibility as major factors behind the predominant use of indigenous medicine. Nevertheless, in these studies, researchers often ignore the third health care option – self-care, usually subjugated under the indigenous medical system. Since the mid-1980s, both biomedical and indigenous health care systems have witnessed transformations that have shaped and changed their modes of operation, as well as the cost of treatment. In light of this, the author seeks to understand the motivations behind the preference for and use of self-care, professional biomedical care, and indigenous forms of care in the context of Ghana’s health care system. A qualitative, in-depth interview technique was used for data gathering. Findings from the study revealed that time and cost of treatment were major factors accounting for the predominant use of self-care. The author concludes that the findings challenge the long-held belief that biomedicine is not widely accepted by people in Ghana compared with indigenous medicine. 相似文献
11.
可达性度量方法及应用研究进展评述 总被引：34，自引：8，他引：26
可达性一直是地理学、土木建筑工程设计、交通运输经济学等学科的研究热点。已有的各 种可达性度量方法目前已广泛应用于交通网络与城镇发展研究、交通基础设施的区域经济效应 评价、选址分析、园林景观规划、社会文化等多个研究领域。随着应用需求的持续加大和技术研究 的不断深入, 可达性度量方法也在快速发展, 其度量体系正在形成。本文首先从两个层面对可达 性的涵义进行全面阐述; 在此基础上, 从网络特性的角度对拓扑法、距离法、累积机会法、等值线 法、重力模型法、平衡系数法、时空法、效用法等目前常用的可达性度量方法进行系统分类, 并且 从可达性影响因素入手对各种度量方法进行综合比较与评述; 然后, 针对不同的应用领域, 对各 种度量方法的应用研究现状进行详细论述与剖析; 最后, 对可达性研究的发展方向进行深入讨论 与展望。 相似文献
12.
广州市医疗设施可达性模型中端点吸引的影响因素检验 总被引：4，自引：3，他引：1
引入出租车GPS数据对医疗设施端点特征指标、服务端特征指标、环境要素指标等进行检验,衡量这些指标对医疗设施端点吸引量和主要服务范围的影响作用。结果显示医疗服务利用符合距离衰减规律,1.5 km内人数最多,超过1.5 km,随距离增加出行人数逐渐减少;医疗设施吸引量受医院规模、所在地区人口数量的正向影响,主要服务范围受到所在地区人口数量的负向影响,其他指标影响不显著。 相似文献
13.
基于改进潜能模型的城市医疗设施空间可达性——以上海市杨浦区为例 总被引：5，自引：2，他引：3
引入人口规模因子和医疗设施等级规模影响系数改进潜能模型,基于GIS空间分析技术,以上海杨浦区为例对其医疗设施空间可达性进行研究。结果表明：杨浦区医疗设施空间可达性分布不均,大桥街道、定海路街道及殷行街道部分区域医疗设施空间可达性较高;中部区域一些街道存在同等级医院位置密集、医疗资源相对集中的情况;杨浦区三级医院的居民就医空间可达性整体优于二级、一级医院。改进的潜能模型综合考虑了居民点人口数量、医疗设施与居民点之间的出行阻抗、以及医疗设施的等级规模对居民就医选择的影响,能更合理地评价医疗设施的可达性。研究结果可为城市医疗设施科学规划与决策提供依据。 相似文献
14.
医疗设施可达性空间差异及其影响因素——基于上海市户籍与流动人口的对比 总被引：6，自引：4，他引：2
医疗设施可达性关乎民生健康、生活质量和社会公平等重大社会议题,受到广泛关注。将空间视角和社会视角相结合,考虑流动人口和户籍人口在城市不同区域内可达性的差异,将有助于更加全面地反映当前城市医疗服务的资源配置及其社会公平问题。本文以上海市不同等级医疗设施的可达性为研究对象,利用改进潜能模型和多元线性回归模型,分析了城市中不同区域内医疗设施的可达性、户籍人口和流动人口就医可达性差异及其影响机理。研究发现：医疗设施可达性自内城区向郊区逐渐降低,郊区可达性的波动程度较大;户籍人口的就医可达性优于流动人口,2类人群的差异在中心城边缘区和近郊区最为明显;居住地区位显著影响居民的就医可达性,但对于户籍人口的影响更加显著。本文可为上海市医疗资源的空间配置优化和改善流动人口就医条件提供实证研究依据。 相似文献
15.
公共服务设施可达性及其对新建住房价格的影响——以北京中心城为例 总被引：8，自引：0，他引：8
本文基于北京市公共服务设施的地理空间信息数据, 采用最短距离指标定量分析了商品 住房对教育、医疗、体育、文化、商业、绿地公园等6 大类公共服务设施的空间可达性( 以下简称 “可达性”) , 并通过Hedonic 特征价格模型定量分析可达性对商品住房价格的影响。研究结果表 明: 1) 按照“最短距离”可达性比较, 商品住房对绿地公园、医院和健身场所可达性最好, 而对大型 商场、文化设施、体育场馆的可达性较差; 2) 按照商品住房的区位和价格比较, 城市四环以内和高 价商品住房组别对公共服务设施的可达性明显优于其它组别; 3) 特征价格模型的定量分析表明, 重点高中、球类场馆、文化设施和绿地公园这4 种公共服务设施的可达性越好, 则商品住房价格 越高, 即目前北京市公共服务设施的规划布局在一定程度上被资本化入商品住房价格。 相似文献
16.
北京城市居民服务设施可达性偏好与现实错位 总被引：7，自引：1，他引：6
服务设施可达性对于居民生活质量的重要性越来越受到国内外研究和城市规划的广泛重视,然而中国城市发展过程中却暴露出服务设施可达性下降的问题。从居民的视角出发,构建影响中国城市居民服务设施可达性偏好与现实错位的分析框架。在此基础上,分析了基于北京市2005 年居住环境调查主观数据对居民的服务设施可达性偏好。利用北京城市服务设施空间数据借助GIS评估居民的客观服务设施可达性,通过多元回归模型讨论居民服务设施可达性偏好与现实的错位情况和相关因素并侧重验证城市空间结构和住房获取渠道的影响,这些因素与中国的城市发展和住房政策变化紧密相关并将基于此提出促进居民实现其服务设施可达性偏好的城市规划和政策建议。 相似文献
17.
《Urban geography》2013,34(8):1039-1064
In recent years, there has been increasing awareness about the impact of urban time policies on the quality of people's everyday lives. However, within the urban planning field, evaluations of public service delivery have primarily focused on the spatial rather than the temporal organization of public service facilities. This study tries to fill this gap by using space-time accessibility analysis to explore the extent to which changes in open hours affect the social equity of service provision. To this end an accessibility model is implemented and employed in a case study of public service provision in the urban area of Ghent, Belgium. Our analysis not only demonstrates that access to public services exhibits substantial hour-to-hour and day-to-day variations, but it also shows that individuals with certain personal and household attributes are affected differently by changes to the temporal regime of public service facilities. 相似文献
18.
广州市城中村农民工医疗行为及其空间特征——以新凤凰村为例 总被引：1，自引：1，他引：0
运用结构式访谈和深度访谈的调查方法,以城中村的农民工为研究对象,分析其医疗行为及空间特征,并探讨其形成原因。研究发现:城中村的农民工医疗保健水平低,医疗机构的使用率低;在医疗制度不完善的背景下,农民工能动地通过各种途径解决医疗需求,形成三种类型的医疗行为模式,即"自力更生"型、"社会资本"依赖型及"经济实力"型。结合医疗机构的空间分布,农民工医疗行为的空间特征符合距离衰减规律,同时表现出明显的波动性,表现为一个跳跃式五圈层结构。本研究试图为改善农民工的健康行为模式提供科学基础,并在一定程度上补充国内城市保健地理及行为地理的研究。 相似文献
19.
《Urban geography》2013,34(2):107-127
Rapid progress of the market-oriented reform in Russia has led to the emergence of urban housing markets. The intraurban spatial differentiation in market valuation of housing suggests a conceptually new insight into the internal structure of the socialist city. This paper demonstrates that apartment prices in Moscow are largely determined by accessibility to the center of the city, social status of the neighborhood residents, and proximity to certain amenities such as recreational facilities or disamenities such as noxious industries. 相似文献
20.
长春市大型零售设施空间可达性绩效测度 总被引：1，自引：1，他引：0
对传统的空间可达性测度模型进行改进,并引入营业面积,人口数量,消费者偏好等变量,对长春市大型零售设施进行研究,通过ArcGIS平台对零售设施的分布特征进行分析后表明:① 零售设施主要分布在城市三环路以内,在一环路传统商业区集聚程度最高;快消零售设施空间分布的向心性显著,呈单中心的集聚特征;耐消设施分布的离心化相对明显,呈双中心的集聚特征.② 综合,快消设施可达性绩效高值区集中在一环内,绩效指数向外递减时存在阶梯性,南北方向递减速度高于东西方向,城市南部三环路以外绩效水平最低;耐消设施绩效高值区在空间上分散分布.③ 快消设施绩效低值区是近年来长春市居住空间扩散的主要区域,零售设施的空间配置严重滞后于城市的空间拓展与人口的郊区化趋势.零售设施空间可达性绩效测度是一种关联了供需双方面因素,测量零售设施服务分配到单位消费者水平的方法. 相似文献