Spatial accessibility of medical services in mountainous regions based on modified two-step floating catchment area method:a case study of Shizhu County, Chongqing
Poverty-stricken mountainous areas often experience a severe shortage of medical resources, with uneven distribution and poor service capacity. This study uses the modified two-step floating catchment area method to analyze the characteristics of spatial accessibility of medical services in Shizhu County, Chongqing Municipality, southwestern China. It explores factors affecting the spatial accessibility of medical services from a supply and demand perspective, aiming for providing decision support for the planning of medical resources space allocation of mountainous regions. The basic unit of analysis is natural villages. Results show that:(1)Overall, the spatial accessibility of medical services in Shizhu County is poor and below the average level in Chongqing Municipality.(2) Medical resources distribution is uneven and the spatial differentiation is very clear.High accessibility areas mainly concentrate in the low and middle mountain areas of Fangdou Mountain and Huangshui Town. Low accessibility areas mainly concentrate in the high mountainous areas of northern Qiyao Mountain and middle mountain areas of southern Qiyao Mountain. The difference in accessibility is significant.(3) Scale and grade of hospitals and grade and density of roads have certain effect on accessibility: Accessibility is generally good in places near the county seat and have a dense road network.(4) Accessibility is high in places of dense road network.(5) With the increase of the distance impedance, accessibility gets better within the county but deteriorates at the peripherals of the villages and towns. The range of accessibility is lower,differentiation of spatial accessibility of medical services shrink, and the influences of the villages and towns with sufficient medical resources on accessibility of surrounding villages and towns increase.