- 规划与建设
- 文章编号：1009-6000(2025)09-0097-08
- 中图分类号：TU984.14 文献标识码：B
- Doi：10.3969/j.issn.1009-6000.2025.09.014
- 项目基金：国家自然科学基金面上项目“新规划体系和‘双碳’目标国家重大战略下的特大城市交通协同规划方法研究”（52278065）；国家自然科学基金面上项目“公平和可达双重维度下的大城市公共交通实质性优先分析方法与优化”（51778277）。
- 作者简介：周鹏飞，南京大学建筑与城市规划学院，硕士研究生；
石飞，通信作者，南京大学建筑与城市规划学院，教授，博士生导师。
- 基于多模式动态时空可达性的三级医疗服务公平评估——以南京市中心城区为例
- Examining Equity of Tertiary Healthcare Services Based on Multi-Modal Dynamic Spatiotemporal Accessibility: A Case Study in Nanjing Central District
- 周鹏飞 石飞
- ZHOU Pengfei SHI Fei
- 摘要：
促进医疗公平是实现城市可持续发展的前提。作为评估公平的重要维度，现有医疗可达性研究对时间维度的考量不足。文章以南京市中心城区为例，基于高德 API 获取小汽车和公共交通 2 种方式在 5 个研究时刻的实时出行时间，考虑门诊开放状态建立高斯两步移动搜寻法计算时空可达性，采用基尼系数、可达性差异指数和双变量局部莫兰指数评估医疗公平的不同维度。结果表明：①采用小汽车就医区域间公平差距较小但对交通拥堵较为敏感，采用公共交通就医对医院可用性更为敏感；②不同模式可达性空间格局存在差异：小汽车方式下呈现圈层扩散分布，而公共交通方式下呈现“中心 + 组团”并沿轨道交通线路轴向扩张；③基于时空可达性的医疗公平在研究时刻内动态变化，医院全部开放的平峰时段可达性与公平性最佳。文章可为我国新型城镇化进程中医疗资源的公平配置和包容城市政策制定提供参考。 - 关键词：
动态时空可达性；医疗公平；三级医院；多出行模式；高斯两步移动搜索法 - Abstract: Promoting healthcare equity is a crucial prerequisite for achieving sustainable urban development. As a vital dimension of equity assessment, the main streams of research on healthcare accessibility lack sufficient consideration of the temporal dimension. Taking Nanjing’s central urban area as an example, this paper utilizes the AMAP API to obtain real-time travel cost for both driving and public transport modes during 5 study moments. Considering outpatient opening status, a Gaussian 2-step floating catchment area (G2SFCA) method is established to calculate the spatiotemporal accessibility. The Gini coefficient, the modal accessibility gap, and the bivariate localized Moran index are used to evaluate several aspects of healthcare equity. The results indicate: ①Smaller interregional equity gaps in access to healthcare by driving mode but more sensitive to traffic congestion, while the use of public transport is more sensitive to healthcare availability. ②There are differences in accessibility spatial patterns between the 2 travel modes: the driving mode shows a circular diffusion distribution, while the public transport mode shows “center + clusters” and tends to expand along the axis of rail transit lines. ③Healthcare equity based on spatiotemporal accessibility varies dynamically within the study moments, with accessibility and equity best during off-peak hours when facilities are fully open. This paper can provide references for the equitable allocation of healthcare resources and the formulation of inclusive urban policies in China’s new urbanization process.
- Key words: dynamic spatiotemporal accessibility; healthcare equity; tertiary healthcare services; multiple travel modes; Gaussian 2-step floating catchment area method