广州市城中村农民工医疗行为及其空间特征——以新凤凰村为例

运用结构式访谈和深度访谈的调查方法,以城中村的农民工为研究对象,分析其医疗行为及空间特征,并探讨其形成原因。研究发现:城中村的农民工医疗保健水平低,医疗机构的使用率低;在医疗制度不完善的背景下,农民工能动地通过各种途径解决医疗需求,形成三种类型的医疗行为模式,即"自力更生"型、"社会资本"依赖型及"经济实力"型。结合医疗机构的空间分布,农民工医疗行为的空间特征符合距离衰减规律,同时表现出明显的波动性,表现为一个跳跃式五圈层结构。本研究试图为改善农民工的健康行为模式提供科学基础,并在一定程度上补充国内城市保健地理及行为地理的研究。

Health care behavior and its spatial characteristics of the floating workers in urban villages of Guangzhou City: Case study in Xinfenghuang Village

China's national medical system is being reformed, while floating workers are excluded outside the system. Current research shows that the general health situation of floating workers is rather miserable, such as poor working and living conditions, low health capacity, lack of health care awareness and so on. Due to inadequate health awareness and low economic status, they seldom make full use of public health care infrastructures to fulfil their medical needs, of which health guidance and regular body check top the priority. Their health care behaviors, health care seeking strategies and accessibility to medical services are almost ignored in recent years. Based on quantitative and qualitative survey, field investigation, as well as mapping of health facilities, we chose one of the typical urban villages-Xinfenghuang Village as a case study and conducted further research. The main purpose of this paper is to evaluate the health situation of floating workers, accessibility of different kinds of health facilities and to clarify the characteristics of their health care behaviors, in order to bring about practical suggestions on improvement of life quality of floating workers in urban villages. Although the geographical accessibility of health facilities is quite high, their real use is affected by several negative factors, including long waiting time, being unable to afford the direct expenses and medicine, inconvenient time and having difficulty asking for leave and so on. Thus they try to meet their medical needs in different ways, which can be divided into three groups in terms of characteristics: self-reliance, social capital reliance, and economic reliance. The most outstanding characteristics of self-reliance group are to cope with the diseases by themselves, like taking medicine without action. The group of social capital reliance can get help from social network consisting of relatives, countrymen and neighborhoods. The group of economic reliance, which is very small, positively responds to health problems because of their better economic status than the others. From spatial perspective, the health care behavior of floating workers accords with the disciplinarian of distance-decay, which forms a five-ringed structure. The medical needs of floating population should be considered into the planning of health care infrastructures and promotion of national medical system.