共查询到20条相似文献，搜索用时 421 毫秒
1.
Hospital service areas (HSAs) capture most of local patient-to-hospital travel flows, and have been accepted as the most basic unit for analyzing local hospital utilization and hospitalization patterns. If a given HSA includes multiple hospitals providing care for its residents, it is complicated to assign responsibility for small-area variation in hospital performance or healthcare costs to specific hospitals without established HSA managers. The goal of this study is to produce HSAs with the fewest number of hospitals within an HSA unit. Only a very limited number of studies are related to the HSA delineation. This study reviews the existing approaches to delineate a broader range of service areas besides HSAs. A spatial algorithm named Travel-to-Hospital Algorithm (TTHA) was developed and implemented using the individual hospital discharge records from the Florida State Inpatient Database for 2011. The final output, named the TTHA-derived HSAs, included 14 more eligible divisions in Florida than the HSAs produced by the traditional approach (92 vs. 78), with the degree of self-containment comparable between the two sets of HSAs. The TTHA provides insight into the patterns of hospital visits and holds great value for the delineation of other types of service and catchment areas. 相似文献
2.
Hospital service areas (HSAs) are increasingly adopted as a basic analysis unit for health care studies. The popular Dartmouth HSAs were produced more than two decades ago, and the process was far from automated. This research uses a Huff-based model automated in a geographic information systems (GIS) environment to delineate HSAs. Based on the Florida State Inpatient Database (SID) in 2011, a best-fitting distance decay function is derived from the actual travel patterns of hospitalization and then fed into the Huff model to strengthen the model's theoretical foundation in individual spatial behavior. The HSAs derived from the Huff-based model are then compared to the traditional flow-based HSAs defined by the Dartmouth method and assessed in terms of self-containment and heterogeneity of internal socioeconomic structure and urbanicity. The Huff-based model requires fewer data and is easy to implement as an automated toolkit and thus has great potential for replication in other regions to define large-scale and consistent HSAs. 相似文献
3.
Improving maternal health is one of the Sustainable Development Goals. Hospital service areas (HSAs), which contain most hospitalization behaviors at the local scale, are crucial for health care planning. However, little attention has been given to HSAs for maternal care and the hierarchy structure. Considering Hubei, central China, as a case study, this study aims to fill these gaps by developing a method for delineating hierarchical HSAs for maternal care using a network optimization approach. The approach is driven by actual patient flow data and has an explicit objective to maximize the modularity. It also establishes the hierarchical structure of maternal care HSAs, which is fundamental for the planning of hierarchical maternal care and referral systems. In our case study, 45 secondary HSAs and 22 tertiary HSAs are delineated to achieve maximal modularity. The HSAs perform well in terms of indices such as the Localization Index and Market Share Index. Furthermore, there is a complementary relationship between secondary and tertiary hospitals, which suggests the need for referral system planning. This study can provide evidence for the validity of the HSA and the planning of maternal care HSAs in China. It also provides transferable methods for planning hierarchical HSAs in other developing countries. 相似文献
4.
The Hospital Service Areas (HSAs) better portray underlying local patterns of hospitalization than administrative units, and offer a promising analysis unit for studies of healthcare market. The widely used Dartmouth HSAs in the U.S. were solely based on Medicare inpatient records about two decades ago. Our analysis used all discharge records from Florida hospitals in the 2011 Healthcare Cost and Utilization Project (HCUP) dataset from the Agency for Healthcare Research and Quality (AHRQ). We first matched Medicare-paid hospitalization records in 2011 to the Dartmouth HSAs for demonstrating the temporal variation of the Medicare-derived HSAs. We then compared the HSA configurations based on the overall hospitalization records to Medicare-derived HSAs in the same year (2011) for assessing the representativeness of the Medicare-derived HSAs. Results indicate the boundaries of the Medicare-derived HSAs have significantly shifted over two decades and are inadequate in representing the overall population. The Huff model was used to generate more solid HSAs than traditional approaches. 相似文献
5.
新重力P中值模型及其在城市综合医院区位决策中的实证检验——以无锡市为例 总被引：1，自引：0，他引：1
区位—分配模型是实现公共服务设施最适配置的有效方法之一。传统的P中值模型以效率作为导向,采用“邻近分配”规则,不考虑设施容量(规模),难以适应城市综合医院供需之间相互作用规律下适度均衡、居民随机概率式选择和区位与规模同步求解的布局要求。本文尝试以P中值模型为基础框架,在对P中值模型来源及其适用性进行分析的基础上,构建出基于供需双方(居民—综合医院)空间相互作用的重力P中值模型。新模型通过纳入“邻近就医”最大出行成本因子,确保居民至少邻近1所综合医院(保障空间公平);通过追求总加权出行成本最小化,确保设施空间配置效率;通过纳入设施容量规模因子实现设施区位和规模同时求解;通过纳入最小规模因子,保障设施规模效率和服务质量公平。进一步通过无锡市区综合医院空间配置进行实证检验发现：采用新模型优化后,综合医院空间配置更加公平、居民邻近就医更加便捷,且能够实现与社区卫生设施协同布局,使整个医疗设施体系空间布局更加合理。本文构建的新重力P中值模型(模型的变量参数可作适当调整)可用于竞争型公共设施区位决策,为相关设施布局调整或者规划提供决策依据。 相似文献
6.
基于网络分析的城市影响区和城市群空间范围识别 总被引：4，自引：3，他引：1
以不打破行政界线为前提,利用Huff模型,基于矢量数据,采用最短交通路网距离和城市综合规模值来综合测算腹地与中心城市之间的势能,根据势能确定腹地县域的归属,对全国地级及以上城市的空间影响范围进行识别,并和基于改进场强模型的城市影响腹地范围界定结果进行对比。以全国发育较成熟的15个城市群为对象,综合测定城市群的影响范围,并与城市群规划中的空间范围进行对比,提出城市群空间范围调整建议。并以长株潭城市群为例,通过社会网络分析方法,综合分析测定城市群的空间影响范围。研究结果可为城市(群)规划提供科学依据和方法参考。 相似文献
7.
Fahui Wang 《The Professional geographer》2018,70(2):251-260
The popular two-step floating catchment area (2SFCA) method has been widely used in the literature to measure spatial accessibility of residents for a service. The 2SFCA method accounts for the ratio between the supply capacity and demand amount of the service as well as the complex spatial interaction between them. This article introduces an inverted two-step floating catchment area (i2SFCA) method that is derived from an extension of the classic Huff model and used to capture the “crowdedness” (scarcity of resource or intensity of competition) for facilities. The method is illustrated and validated by a case study of evaluating hospital inpatient services in Florida. Several possible uses of the measure are also discussed. 相似文献
8.
就医空间可达性分析的两步移动搜索法——以江苏省东海县为例 总被引：8，自引：5，他引：3
精确评价医疗设施可达性的空间分异样状况是合理配置医疗资源的前提。本文在回顾国内外关于医疗空间可达性研究的基础上, 采用两步移动搜索法, 以江苏省贫困县--东海县为案例, 以行政村和医院为分析单元, 基于迪卡斯特拉算法计算出各村到医院(卫生院)的最短通行时间, 进而分析各村医疗空间可达性分异情况。采用不用服务时间阈值范围进行空间敏感性分析, 综合研判缺医地区分布特点。与传统的医卫人员和人口比值的方法相比, 两步移动搜索法能有效显示县域范围内医疗可达性的空间分异情况。采用较大的时间阈值, 医疗空间可达性分异较为平滑, 采用较小服务阈值则空间分异显著, 缺医范围也较大。东海县医疗空间可达性整体呈单核结构, 并沿主要交通线延伸, 缺医地区多分布于边缘乡镇。提高边缘乡镇的行政村的甲级卫生院等级和乡村道路等级将会改善边缘乡镇的就医可达性。 相似文献
9.
空间可达性是衡量公共服务设施公平性的重要指标,在医疗、教育、休闲等公共服务的布局规划中得到广泛应用。然而已有设施服务可达性模型难以充分反映服务供需关系,计算指标也缺乏物理意义。本文提出新的最优供需分配的公共设施空间可达性计算方法（OSD）取代现有方法。该方法基于最优供需分配模型,将设施服务分配给需求者,根据分配结果计算空间可达性指标。给定服务设施与需求的空间分布,以最小化旅行成本为目标,顾及设施服务能力,采用经典的运输问题模型确定最优的服务供需分配方案,进而度量服务的空间可达性。以郑州市金水区社区卫生服务为例,求解25个中心与1333个居住小区的最优服务配置。使用最优配置结果确定每个设施的服务范围、每个居住小区使用服务的旅行时间,以及特定时间阈值的服务覆盖比率。与流行的两步移动搜索法相比,新方法的计算指标具有明确的物理意义。本文提出的可达性评价方法无需参数,计算高效,结果易于解释,在公共服务评价及设施布局规划方面具有应用潜力。 相似文献
10.
居住区是居民日常生活最基本的空间单元,其建成环境对出行碳排放的影响是学术界关注的焦点。基于大样本调查数据核算居民各类出行碳排放,通过POI抓取、空间句法、网络分析等方法识别开封市主城区成规模的248个居住区的建成环境特征,借助核密度和GWR等方法剖析居住区尺度居民各类出行碳排放的空间分异规律。结果表明：① 城市内部居民出行碳排放空间差异显著,居住区公共服务供给的公平性问题突出,外圈层快速扩张区域应作为城市碳减排工作的关键区域;② 居住区尺度能较好地揭示建成环境对出行碳排放的影响,路网设计、建筑密度、土地利用混合度等因素对各类出行碳排放的作用机理差异较大,作用强度亦存在不同方向上的空间渐进规律;③ 根据出行碳排放结构及其对应的建成环境指标可识别出外层高密度欠通达低混合型居住区碳排放水平较高,内层低密度高通达高混合型居住区碳排放水平较低。研究结果可为居住区空间重构和城市碳排放的分区规划与治理提供科学依据。 相似文献
11.
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
12.
竞争型公共设施区位决策——概念、选址原则及模型构建 总被引：4，自引：3，他引：1
竞争型公共设施竞争性、公益性并存,其区位决策相对更加复杂。首先提出了“竞争型公共设施”的概念,指出“兼顾效率与公平的空间均衡”是其选址的基本原则,并概括出具体选址要求：遵循供需双方的空间相互作用模式、限制至邻近设施的最大出行成本、追求总出行成本最小化、约束设施规模门槛、与低层级设施在出行成本上相区分等。其次构建了基于概率分配规则的重力P中值模型,通过纳入设施规模因子实现区位和规模同步求解,并对邻近设施最大出行成本和设施最小规模进行约束,以实现空间公平-效率、服务质量公平与规模效率等多重目标。最后经过实证检验,优化后的设施布局更为均衡合理。 相似文献
13.
城市群作为城镇化高级阶段区域社会经济发展和参与国际竞争的主要空间载体,良好的交通通达性是其高质量发展的必要条件。以《交通强国建设纲要》提出的城市群2h通达目标为研究视角,以长江经济带3个国家级城市群为研究对象,选取加权平均出行时间作为测度指标并引入场强和引力模型,对比分析3个城市群所有城市与中心城市两个层级2h出行交通圈格局特征。研究发现：① 3个城市群出行交通圈均表现为从中心向外围地区呈现出由低到高连续扩大的“圈层式”空间格局特征,且长三角和成渝城市群分别形成了“>”字型和“十”字型2h出行廊道,但长江中游城市群尚未形成2h出行廊道。② 城市群中心城市2h出行交通圈的空间分布受区位条件影响较大,越接近区域几何中心则2h出行交通圈覆盖范围越大,而影响腹地受中心城市综合规模的作用明显,3个城市群各中心城市2h出行交通圈和影响腹地的空间分异显著。③ 不同城市群中心城市2h出行交通圈衔接联系水平差异显著,表现出多元的圈层叠加的经济联系格局。④ 高密度高速公路路网在提高城市群中心城市2h出行交通圈衔接联系水平中发挥重要作用,按衔接联系模式特征可将各城市群总结为多中心网络型、多中心组团型与双中心轴辐型。 相似文献
14.
The debate on scale in geography has yielded nuanced concepts that have enhanced scale analysis and methodologies for scale‐related research. Despite this advancement, questions still linger on the value of scale as a geographical vocabulary, partly because scalar analyses remain predicated on hierarchies, which have limited explanatory power. In this paper we draw on insight from political ecology to affirm and expand on the usefulness of scale for geographical inquiry and for engaging with contemporary people–environment relations. In particular, the paper appreciates that ecology is at the core of methodological questions pertaining to the explanation of these relations and is increasingly involved in the construction of biodiversity discourses and strategies that rely heavily on conceptions of, and pronouncements on, scale. We use the concept of scalar thickness as a way of thinking about how spaces of conservation are organized and the propensity of scales to coalesce at various stages of scale‐producing processes. We argue that wildlife management areas in Tanzania have played a pivotal role in the thickening of the micro scale in the southeast region. These areas constitute the scale at and though which global conservation agendas are implemented and natural resource rights and benefits are contested. 相似文献
15.
北京典型行业微区位选址比较研究——以北京企业管理服务业和汽车制造业为例 总被引：5，自引：2，他引：3
以微观企业数据为基础,采用核密度空间平滑和条件逻辑选择模型等方法,重点关注企业在城市内部微观尺度下的区位选择,并对北京典型现代服务业和制造业区位选择的差异进行对比分析。结果表明：① 北京中小型制造企业倾向于在集聚区分布,符合马歇尔式产业集群的特征,而服务业则是大型企业更倾向于集中布局;② 尽管微观尺度下多样化和上下游产业链对现代服务业和制造业依然有重要影响,但是与宏观尺度下不同的是对于现代服务业来说过度多样化并不利于其发展,对于制造业来说区域专业化劳动力规模而非专业化程度更为重要;③ 政府对地铁等公共设施布局选址将对现代服务业的微观区位产生重要影响。 相似文献
16.
Zhenghua Hu Guofeng Wang Jiye Wang Lingkui Meng 《International journal of geographical information science》2017,31(11):2216-2233
This paper introduces a robust method for computing the optimal route with hierarchy. We convert a planar road network into its Voronoi-based counterpart with multiple levels of detail (LoDs), which is subsequently assigned travel times that are estimated for different times of day using taxicab trajectory data. On the basis of this network structure, we model the path-finding process in travel, as the optimal route with hierarchy is computed in a ‘coarse-to-fine’ manner. In other words, the route is iteratively constructed from roads in a low LoD network to roads in a high LoD network. To confirm the efficiency and effectiveness of our method, comparative experiments were conducted using randomly selected pairs of origins/destinations in Wuhan, China. The results indicate that our travel lengths are on average 12% longer than those computed by the Dijkstra algorithm and 15% shorter than those computed by the hierarchical algorithm (in ArcGIS). Our travel times are on average 29% longer than those computed by the Dijkstra algorithm and 31% shorter than those computed by the hierarchical algorithm (in ArcGIS). Hence, we argue that our method is situated in terms of performance between the Dijkstra algorithm and the hierarchical algorithm (in ArcGIS). Moreover, road usage patterns confirm that our algorithm is cognitively equivalent to the hierarchical algorithm (in ArcGIS) by favoring high-class roads and outperforms the Dijkstra algorithm by avoiding choosing low-class roads. Computationally, our method outperforms the Dijkstra algorithm but is on the same level as the hierarchical algorithm (in ArcGIS) in terms of efficiency. Therefore, it has the potential to be used in real-time routing applications or services. 相似文献
17.
中国粮食生产空间关联网络的结构特征及其形成机制 总被引：3，自引：3，他引：3
基于1996—2018年中国省际粮食生产面板数据,在修正的引力模型准确测算粮食生产空间关联关系及构建空间关联矩阵的基础上,首先运用社会网络分析方法从整体特征、个体特征及块模型3个方面具体考察了粮食生产空间关联网络的结构特征,进一步采用二次指派程序方法探讨其形成机制。研究发现：① 省际粮食生产空间关联的密切程度在波动中提高,但仍有提升空间,网络结构呈现较好的稳定性和可达性,溢出效应具有多重叠加特性;② 省际粮食生产空间关联网络呈现主产区、主销区、平衡区“核心—边缘”分布格局,粮食主产区在网络中处于核心地位,粮食主销区和平衡区则处于边缘地位;③ 粮食生产空间关联网络可划分为净溢出、主受益、经纪人和双向溢出4个板块,板块间的溢出效应具有明显的梯度传递特征;④ 自然禀赋条件与社会经济因素的共同作用推动了粮食生产空间关联网络的形成,地理空间邻近性、经济发展水平与农村劳动力规模、机械服务规模、耕地资源的差异、降水量和日照时数的相近性对粮食生产空间关联网络的形成具有显著影响。 相似文献
18.
地形信息对确定DEM适宜分辨率的影响 总被引：2，自引：0，他引：2
分辨率会直接影响基于栅格数字高程模型（DEM）的数字地形分析结果,因此在实际应用中,需要选择适宜的DEM分辨率。目前采取的基本方法,基于某种地形信息定量刻画尺度效应曲线,从而确定DEM适宜分辨率,但对于采用不同地形信息时所产生的影响尚缺乏研究。本文针对该方法中通常采用的坡度、剖面曲率、水平曲率等3 种地形信息,每种地形信息提取时,分别使用两种不同的常用算法,在3 个不同地形特征的研究区中,逐一计算其在不同分辨率下的局部方差均值,以刻画尺度效应曲线,确定相应的DEM适宜分辨率,并进行对比分析。结果表明：① 采用剖面曲率或水平曲率所得适宜分辨率结果基本相同,但采用坡度所得出的适宜分辨率结果则有明显差别,后者所得的适宜分辨率更粗;② 采用不同地形信息时,越是在平缓地形为主的研究区,所得的适宜分辨率结果越相近,在复合地形特征的研究区所得到的适宜分辨率区间均明显较宽;③ 地形属性计算时所用的算法对适宜分辨率结果的影响不明显。 相似文献
19.
Joaquín Márquez-Pérez José I. Álvarez-Francoso 《Geografisk tidskrift / udgivet af Bestyrelsen for Det Kongelige danske geografiske selskab》2017,117(1):53-62
An increase in walking or hiking activities in natural areas requires improvements in information and advice about trails, including their difficulty, available services and estimated travel time. Comparative studies show remarkable differences between measured and calculated travel times obtained by available predictive procedures (Naismith’s rule, Tobler’s hiking function or MIDE). A new procedure has been designed by combining pre-existing methods (Tobler’s and MIDE), and travel times have been calculated for 21 trails located in different protected natural areas of Spain. Times obtained are compared with travel times measured by individual users and uploaded into specialized walking-hiking websites (Wikiloc). Results show that the new procedure (Modified Tobler) reduces differences between calculated and measured travel times, which makes it suitable not only for trail managers to estimate travel times but also as a key part of pedestrian transport analysis in trail networks. 相似文献
20.
基于机构分层分析框架,运用统计与空间分析方法,剖析中国省域基层医疗卫生机构和医院医疗资源配置与服务利用协调发展的时空演化特征及其驱动因子。研究发现:2010—2018年2类机构的耦合协调类型由濒临失调衰退型变为勉强协调发展型;总体呈东部经济发达地区水平较高,中部地区居中,西北、东北、西南等经济欠发达沿边地区较低的空间分布格局和以长江中下游地区和青藏高原地区为核心的热、冷点区的空间聚集特征,同时在空间格局改善程度、局部空间集聚效应强度和冷热点区变化范围等方面存在差异;受人口分布与结构、经济发展水平和地理空间等因子驱动,同时存在明显时空异质性特征。 相似文献