摘要
揭示医疗与贫困的作用关系,是探究因病致贫、因病返贫现象的重要内容。通过构建医疗资源指数与医疗设施可达性评价指标,分析了2008—2017年中国集中连片特困地区677个县域医疗可达性与贫困的时空特征,并通过选取更优的空间误差模型分析了医疗可达性对贫困的影响。结果表明:(1)中国集中连片特困地区贫困呈现波动上升的特点,并具有明显的空间集聚特征,空间差异呈现出前期基本稳定、后期快速增加的阶段性特征。(2)医疗资源指数由整体较低转变为胡焕庸线东南侧较高、西北侧较低的分布格局,医疗资源指数格局得到优化;医疗设施可达性由最初各类型较均衡分布转变为以低值为主体的格局,医疗设施可达性有了较大水平提升。(3)医疗可达性可以有效降低贫困程度,集中连片特困地区各县域的医疗资源指数每提高1%会产生0.006%的减贫效应,医疗设施可达性每提高1%会产生0.133%的减贫效应。(4)医疗可达性对不同贫困程度地区的影响具有差异性,相较于低贫困地区,医疗资源指数具有更好的“亲贫性”。至2017年,医疗资源指数每提高1%,对低贫困地区会产生0.047%的减贫效应,而对高贫困地区会产生0.353%的减贫效应;医疗设施可达性只对低贫困地区具有一定的减贫效应,至2017年,医疗设施可达性每提高1%,对低贫困地区会产生0.083%的减贫效应。提升医疗卫技人员数,可以提高总体的医疗资源指数,进而可以提升集中连片特困地区县域的减贫成效,尤其是对高贫困地区的减贫成效。此外,提升居民就医便捷程度比提升医疗资源指数具有更大的减贫效应,但仅限于低贫困地区。
Revealing the relationship between health care and poverty is an important content to explore the phenomenon of poverty and returning to poverty caused by illness.The medical resources index and medical facility accessibility of 677 counties in concentrated contiguous severe poverty areas from 2008 to 2017 were measured.Based on the analysis of spatio-temporal evolution characteristics of poverty and health care accessibility,the impact of health care accessibility on poverty was analyzed by using spatial error model.The results showed that the poverty in the concentrated contiguous severe poverty areas presented a fluctuant increasing characteristic,and it had significant spatial agglomeration.The spatial difference of poverty showed a phased characteristic of basically stable in the early stage and rapid increased in the late stage.The pattern of medical resources index changed from low in whole to high in the southeast and low in the northwest of Hu Line,and the medical facility accessibility has changed from a relatively balanced distribution to the pattern of low value.Health care accessibility can effectively reduce the level of poverty.Every 1%increase in medical resources index of counties in the poverty-stricken areas will produce a poverty reduction of 0.006%.Every 1%increase in medical facility accessibility will produce a poverty reduction of 0.133%.The impact of health care accessibility on different levels of poverty is heterogeneous.Compared to low poverty,the medical resources index has better pro-poverty.By 2017,every 1%increase in medical resources index will produce a poverty reduction of 0.047%in low poverty areas,and 0.353%in high poverty areas.Medical facility accessibility only has a certain poverty reduction effect on low poverty.By 2017,every 1%increase in medical facility accessibility will produce a poverty reduction of 0.083%.By increasing the number of health technical personnel to improve the medical resources index,the poverty reduction effect of counties in the poverty-stricken are
作者
王东华
曹小曙
黄晓燕
WANG Donghua;CAO Xiaoshu;HUANG Xiaoyan(School of Geography and Tourism,Shaanxi Normal University,Xi′an 710119,Shaanxi,China;Northwest Land and Resource Research Center,Shaanxi Normal University,Xi′an 710119,Shaanxi,China)
出处
《陕西师范大学学报（自然科学版）》
CAS
CSCD
北大核心
2021年第2期1-14,共14页
Journal of Shaanxi Normal University：Natural Science Edition
基金
国家自然科学基金(41831284)
陕西省自然科学基础研究计划(2018JM4006)。
关键词
集中连片特困地区
医疗可达性
贫困
影响
concentrated contiguous severe poverty areas
health care accessibility
poverty
impact
