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Spatial Organization of Hierarchical Medical Services within the City Proper of Tianjin, China: Towards Efficient Medical Alliances

Xuan Sun (), Tao Sun (), Yushan Jin () and Ya Ping Wang ()
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Xuan Sun: Zhou Enlai School of Government, Nankai University, Tianjin 300350, China
Tao Sun: Zhou Enlai School of Government, Nankai University, Tianjin 300350, China
Yushan Jin: School of Public Affairs, Zhejiang University, Hangzhou 310058, China
Ya Ping Wang: School of Social & Political Sciences, University of Glasgow, Glasgow G12 8RS, UK

Sustainability, 2019, vol. 11, issue 1, 1-15

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.

Keywords: spatial organization; hierarchical medical services; medical alliance; health care; China (search for similar items in EconPapers)
JEL-codes: Q Q0 Q2 Q3 Q5 Q56 O13 (search for similar items in EconPapers)
Date: 2019
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