A Research on Spatial Accessibility to Paediatric Services in Hualien County

Abstract

This research aims to investigate the spatial accessibility of paediatric clinics in Hualien county. Enhanced Two-Step Floating Catchment Area Method is used to calculate the spatial accessibility (clinic-to-patient ratio) of each village in Hualien. In addition, spatial autocorrelation such as Anselin`s LISA and Getis-Ord`s Gi*(d) were conducted to pinpoint the spatial clusters where paediatric services are most needed. The current distribution of paediatric clinics is concentrated in Huadong valley and Hualien city, leaving 8.74% of children under the age of 18 in risk as they have no paediatric resource accessibility. Through spatial autocorrelation, we can point out the three paediatric service `cold points`: north Hualien, centre-south Hualien and south Hualien. These areas are also being highlighted in past research as resource insufficient regions. Centre-south Hualien is currently covered by Mobile Medicine Program whereas north and south Hualien, especially mountainous regions need more support to improve its spatial accessibility.

本研究使用「進階兩階段流動搜尋法」（Enhanced Two-Step Floating Catchment Area Method）計算花蓮縣各村里小兒科醫療資源的空間可接近性，以了解各村里診所與兒童的人口比例。並透過Anselin`s LISA與Getis-Ord`s Gi*(d)進行空間自相關分析，發掘醫療資源缺乏的空間聚落，提供未來政策規劃參考。研究發現，花蓮縣小兒科醫療資源集中於花東縱谷與花蓮市，全縣有8.74%的兒童醫療資源可接近性為0，是疾病潛在風險群。透過空間自相關性分析，發現花蓮北部、中南部及南部為小兒科醫療可接近性較低的「冷點」，這些聚落在過去的研究中也被點名為資源缺乏區域。雖然健康保險署目前的「巡迴醫療服務」可改善醫療可接近性，但服務範圍僅聚集於花蓮中南部，建議巡迴服務應擴及花蓮北部及南部，以改善醫療可接近性