Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.

In order to improve the operational efficiency of medical institutions and build a more complete and efficient medical system, the Chinese government is vigorously promoting the reform of hierarchical diagnosis and treatment. We constructed a multi-factor composite selection weight to characterize t...

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Main Authors: Zhongyu Wei, Jianjun Bai
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0282713
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author Zhongyu Wei
Jianjun Bai
author_facet Zhongyu Wei
Jianjun Bai
author_sort Zhongyu Wei
collection DOAJ
description In order to improve the operational efficiency of medical institutions and build a more complete and efficient medical system, the Chinese government is vigorously promoting the reform of hierarchical diagnosis and treatment. We constructed a multi-factor composite selection weight to characterize the residents' medical treatment behavior in the context of hierarchical diagnosis and treatment. By combining the weight with the two-step floating catchment area method, we analyzed the spatial variation characteristics of residents' accessibility to medical care under different scenarios. Results show that the referral rate between medical institutions increases gradually along with the occurrence of public health events. When there is a major public health event, the proportion of the population transferred from the primary medical institutions to the county hospitals and the county hospitals to the municipal hospitals exceeded 65%. In three scenarios, the spatial pattern of accessibility shows obvious consistency and local differences. Among the three-tier medical institutions in China, the service capacity of county hospitals is poor, and the contribution rate of accessibility is less than 20%. The results clearly show the spatial differences in the accessibility of Chinese residents in different scenarios and the impact of public health events on accessibility. This research can provide a reference for the layout optimization of medical resources in the future.
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spelling doaj.art-7c99146a952b4f84b7b4bc788ea9c8092023-04-28T05:31:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184e028271310.1371/journal.pone.0282713Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.Zhongyu WeiJianjun BaiIn order to improve the operational efficiency of medical institutions and build a more complete and efficient medical system, the Chinese government is vigorously promoting the reform of hierarchical diagnosis and treatment. We constructed a multi-factor composite selection weight to characterize the residents' medical treatment behavior in the context of hierarchical diagnosis and treatment. By combining the weight with the two-step floating catchment area method, we analyzed the spatial variation characteristics of residents' accessibility to medical care under different scenarios. Results show that the referral rate between medical institutions increases gradually along with the occurrence of public health events. When there is a major public health event, the proportion of the population transferred from the primary medical institutions to the county hospitals and the county hospitals to the municipal hospitals exceeded 65%. In three scenarios, the spatial pattern of accessibility shows obvious consistency and local differences. Among the three-tier medical institutions in China, the service capacity of county hospitals is poor, and the contribution rate of accessibility is less than 20%. The results clearly show the spatial differences in the accessibility of Chinese residents in different scenarios and the impact of public health events on accessibility. This research can provide a reference for the layout optimization of medical resources in the future.https://doi.org/10.1371/journal.pone.0282713
spellingShingle Zhongyu Wei
Jianjun Bai
Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
PLoS ONE
title Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
title_full Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
title_fullStr Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
title_full_unstemmed Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
title_short Measuring spatial accessibility of residents' medical treatment under hierarchical diagnosis and treatment system: Multi-scenario simulation in China.
title_sort measuring spatial accessibility of residents medical treatment under hierarchical diagnosis and treatment system multi scenario simulation in china
url https://doi.org/10.1371/journal.pone.0282713
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