Spatial organization of hierarchical medical services within the city proper of Tianjin, China: towards efficient medical alliances

Sun, X., Sun, T., Jin, Y. and Wang, Y. P. (2019) Spatial organization of hierarchical medical services within the city proper of Tianjin, China: towards efficient medical alliances. Sustainability, 11(1), 229. (doi:10.3390/su11010229)

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Abstract

To address the low performance of health care service delivery in the half-market system, the Chinese government has begun to advocate the medical alliance (MA) recently. Instead of strict regulations on the procedure of diagnosis and treatment, flexible resource sharing among medical institutions of different grades inside each MA is encouraged. By now, many attempts have been made for MA establishment from different perspectives, but there is no effective model maturely developed. For the promotion of the spatial accessibility to medical services at different levels, it is important to organize the hierarchial medial services according to the distributions of different grades of health care facilities in a city. With the city proper of Tianjin as the study case, we explored the optimal establishment of MAs using the geographic information system (GIS). By means of the Voronoi Diagrams, the service regions of different medical institutions were precisely defined and the organizational structure of hierarchical medical services in MAs was determined. Through interpolation analysis, accessibility to different levels of medical services was measured, and on this basis, discussions were conducted on the service efficiency of the MAs. According to the results from Tianjin, (1) under the proposed organizational model for MAs, the fit of the service regions of the first grade and the other two higher grades of medical institutions was good. but the fit of the second and the third grade medical institutions was insufficient. (2) Although the overall service efficiency was excellent, there were still deficiencies in a number of the MAs. (3) Increasing the number of second and third grade medical institutions in specific regions near the city’s edge, as well as the number of first grade institutions, could further improve the performance of hierarchical medical services.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wang, Professor Ya Ping and Sun, Dr Xuan
Authors: Sun, X., Sun, T., Jin, Y., and Wang, Y. P.
College/School:College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:Sustainability
Publisher:MDPI
ISSN:2071-1050
ISSN (Online):2071-1050
Published Online:04 January 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Sustainability 11(1): 229
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
706021The Re-Making of Chinese Urban Neighbourhoods: Spatial and socio-economic transformations and access to public services in Tianjin, Hangzhou, ChengduYa Ping WangEconomic and Social Research Council (ESRC)ES/N010981/1SPS - URBAN STUDIES