Spatial analysis of the distribution, risk factors and access to medical resources of patients with hepatitis B in Shenzhen, China

Spatial Allocation Rationality Analysis of Medical Resources Based on Multi-Source Data: Case Study of Taiyuan, China

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents' medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply-demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a "concentrically decreasing" pattern. The rating ranged from "very reasonable" to "less reasonable", with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as "less reasonable" occupied 38.73% of the total area. These results indicate that the model accounted for residents' travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources.

"We Just Don't Know Where They Are": The Geographical Distribution of Exercise Classes for Older People, Including Those Living with Dementia in the East Midlands

Older people living with dementia are advised to exercise to remain independent. Although several exercise classes for older people take place across the UK, there is limited information about the geographical distribution of these classes. This study identified the location and explored the population characteristics of the classes in a UK region, to aid improved access to exercise. Using a geographical information system, data were collected on population characteristics, including size and age, socio-economic status, and rurality of the exercise classes in one area of the UK (East Midlands, population 5 million). The relationship between data sets was explored and a visual representation of these patterns was provided. A systematic internet search identified 520 exercise classes, evenly spread across the region and areas of socio-economic deprivation: 471 (90%) were in urban areas; 428 (80%) were in areas where less than 20% of the population was over 65 years of age; and 13 (2%) stated that they were suitable for people with dementia. People living with dementia are less likely than older people without dementia to have access to exercise classes.

Assessment of Medical Expenditure for Patients With Breast Cancer in China: Evidence From Current Curative Expenditure by System of Health Accounts 2011

OBJECTIVES

The incidence and mortality of breast cancer have been increasing in China and bring heavy economic burdens to patients, families, and society. This study aimed to analyze the structure and influencing factors of inpatient expenditures of patients with breast cancer and put forward suggestions for insurance management.

METHODS

A multistage stratified random sampling method was used to investigate 379 medical institutions and 7366 pieces of inpatient records of patients with breast cancer in Dalian in 2018. Under the framework of "System of Health Accounts 2011," the current curative expenditure (CCE) and its distribution were calculated. The relationships between hospitalization expenditure and factors were analyzed by multiple stepwise regression and structural equation modeling.

RESULTS

The CCE of patients with breast cancer in Dalian in 2018 was ¥273.38 million, accounting for 10.66% of the total expenditure on cancer. The majority of the CCE flowed to large general hospitals. The CCE was concentrated in patients aged 40 to 69 years (23.46%). The hospitalization expenditure correlated positively with length of stay, surgery, and drug expenses (rs = 0.586-0.754, P < .01) and negatively associated with age (rs = -0.074, P < .01). The length of stay mediated the relationship between surgery and hospitalization expenses for patients with breast cancer. The factors that affected the hospitalization expenditure were the drug expenses, surgery, length of stay, insurance status, and institution level.

CONCLUSIONS

The cost control for CCE of breast cancer inpatient treatment is crucial in China. Promoting hierarchical diagnosis and treatment, reducing the length of stay, and improving medical insurance depth would be effective measures to reduce the financial burden of patients.

Use of GIS Tools in Sustainable Heritage Management—The Importance of Data Generalization in Spatial Modeling

Cultural heritage is a very important element affecting the sustainable development. To analyze the various forms of spatial management inscribed into sustainable development, information on the location of objects and their concentration at specific areas is necessary. The main goal of the article was to show the possibility of using various GIS tools in modeling the distribution of historical objects. For spatial analysis, it is optimal to use the point location of objects. Often, however, it is extremely difficult, laborious, expensive, and sometimes impossible to obtain. Thus, various map content generalizations were analyzed in the article; the main goal was to find the level for which the data with an acceptable loss of accuracy can be generalized. Such analyses can be extremely useful in sustainable heritage management. Article also shows how cultural heritage fits into the sustainable heritage management. The research included non-movable monuments in Poland. The obtained results showed the universality of this type of research both in the thematic sense (can be used for various types of objects) and spatial sense (can be performed locally, at the country level, or even at the continental level).

An Enhanced Variable Two-Step Floating Catchment Area Method for Measuring Spatial Accessibility to Residential Care Facilities in Nanjing

Civil administration departments require reliable measures of accessibility so that residential care facility shortage areas can be accurately identified. Building on previous research, this paper proposes an enhanced variable two-step floating catchment area (EV2SFCA) method that determines facility catchment sizes by dynamically summing the population around the facility until the facility-to-population ratio (FPR) is less than the FPR threshold (FPRT). To minimize the errors from the supply and demand catchments being mismatched, this paper proposes that the facility and population catchment areas must both contain the other location in calculating accessibility. A case study evaluating spatial accessibility to residential care facilities in Nanjing demonstrates that the proposed method is effective in accurately determining catchment sizes and identifying details in the variation of spatial accessibility. The proposed method can be easily applied to assess other public healthcare facilities, and can provide guidance to government departments on issues of spatial planning and identification of shortage and excess areas.