中国地市卫生资源需求测度及其时空格局研究

测度地区卫生资源需求是实施以需求为导向的卫生资源空间配置的前提.综合考虑地区卫生资源需求决定因素及空间相互作用，构建卫生资源需求指数，分析2000年—2010年中国卫生资源需求在地市之间的分布及变化.结果发现，中国卫生资源需求自西向东呈“高－低－高”的总体空间格局.西部的青海、西藏、新疆和川西地区主要因为居民健康需要水平高，卫生资源需求中高值地市连片分布，形成青藏地区高值集聚区和以藏中为核心的中国西部卫生资源需求热点区域.东部沿海地区主要因为卫生服务可及性高，卫生资源需求中高值地市集中分布，形成环渤海、长三角和珠三角高值地市集聚区和以苏浙沪为核心的中国东部卫生资源需求热点区域.中部地域整体上居民健康需要和卫生服务可及性较低，连片分布卫生资源需求低值地市，其中广州、武汉、成都等部分省会城市和豫北地区因卫生服务可及性较高，川云桂黔地区因健康需要水平较高而成为卫生资源需求中高值区，形成以甘川陕晋豫鄂湘为主的低值地市集聚区和以甘陕鄂湘赣为核心的中国卫生资源需求冷点区域.

Measurement of regional demand for health resources and its spatio-temporal pattern in China

Measuring regional health resource demand is a prerequisite for implementing demand-oriented spatial allocation of health resources. Taking the determinants of regional demand for health resources and the spatial interaction into account， the index of demand for health resources is constructed to analyze the distribution of health resources demand among the prefecture-level districts in China and its change from 2000 to 2010. The main results are as follows. The spatial distribution of health resources demand presents “high-low-high” overall pattern from western to eastern China. Mainly due to the high healthcare need of the population， the prefectures with medium-and-high demand for health resources are continuously distributed in the western area including Qinghai， Tibet， Xinjiang and western Sichuan， forming a cluster zone of prefectures with high demand for health resources in Qinghai-Tibet area and a hotspot zone of health resources demand in western China with middle Tibet region as the core. Mainly due to the high accessibility to health services， the prefectures with medium-and-high demand for health resources are concentrated along the east coast， forming cluster belts of prefectures with high demand for health resources in the Bohai Rim， the Yangtze River Delta and Pearl River Delta and a hotspot zone of health resources demand in eastern China with Jiangsu， Shanghai and Zhejiang as the core. Due to the low healthcare need and the low accessibility to health services， the prefectures with low demand for health resources are continually distributed in the middle parts of China， among which some provincial capitals， such as Guangzhou， Wuhan and Chengdu， as well as northern Henan are medium-and-high demand areas with high accessibility to health services. Sichuan， Yunnan， Guangxi and Guizhou are also medium-and-high demand areas because of their high healthcare need. Low demand for health resources mainly cluster in Gansu， Sichuan， Shaanxi， Shanxi， Henan， Hubei and Hunan while Gansu， Shaanxi， Hubei， Hunan and Jiangxi are the core of cold spots of health resources demand.