广东省医疗与养老设施空间格局、适老化与均等性——基于空间可达性的评价

以广东省为例，采用改进两步移动搜索法测算医疗与养老设施可达性，然后采用自相关分析法、基尼系数分析医疗与养老设施的适老化及均等性，最后运用Spearman相关系数对医疗与养老设施可达性及均等性的影响因素进行分析。结果表明：1）改进两步移动搜索法更能准确反映医疗与养老设施可达性，珠三角地区老年人医疗、养老设施可达性相对较好，东、西部沿海经济区相对较差；但珠三角地区养老设施医疗可达性在四大区域中最差。2）广佛都市区、梅州市北部等地区的医疗与养老设施适老化不足，广东省医疗与养老设施可达性存在较大的不均等。3）路网密度、人口密度、人均GDP、公共财政支出与广东省医疗、养老设施可达性显著相关，平均海拔、生态环境状况指数、面积、路网密度、人口密度、人均GDP、公共财政支出与广东省老年人医疗、养老设施可达性的均等性显著相关。

Spatial Pattern,Aging Suitability,and Equality of Medical and Residential Care Facilities in Guangdong Province: An Evaluation Based on Spatial Accessibility

With the rising aging population in China, increasing attention has been paid to the spatial layouts of medical and residential care facilities; however, the accessibility and aging suitability of these facilities have received less attention. Taking Guangdong province as an example, this study used the improved two-step floating catchment area method to measure the accessibility of medical and residential care facilities and summarized their spatial pattern characteristics from four dimensions (1 km, four regions, cities, and counties). A correlation was established between the elderly population density data and their degrees using the autocorrelation analysis method and the Gini coefficient to analyze the aging suitability and equality of medical and residential care facilities. Finally, the Spearman correlation coefficient was used to analyze the factors influencing the accessibility and equality from three aspects, namely: the natural environment, society, and economy. The following results were obtained: 1) Compared with the Gaussian two-step floating catchment area method, the improved two-step floating catchment area method was more accurate in reflecting the accessibility of medical and residential care facilities; this showed that the accessibility of downtown areas was relatively lower and that of the suburbs was relatively higher, and the distribution of accessibility values was more reasonable. The results of the improved two-step floating catchment area method revealed an obvious spatial imbalance in the accessibility of medical and residential care facilities for the elderly and the accessibility of medical facilities for the residential care facilities in Guangdong Province. The accessibility of medical and residential care facilities for the elderly in the Pearl River Delta region is relatively good, whereas that in the eastern and western coastal economic zones is relatively poor. However, the Pearl River Delta region has the worst accessibility to medical care facilities for residential care facilities among the four regions and efforts are still needed to realize a combination of medical and residential care. 2) The medical and residential care facilities in the Guangzhou-Foshan metropolitan area and the northern part of Meizhou city were not suitable for the elderly. There was a substantial inequality in the accessibility of medical and residential care facilities for the elderly in Guangdong Province. The accessibility of medical facilities for the residential care facilities in Guangdong province is more equal, but there is still a large inequality; 15 cities in Guangdong province have Gini coefficients greater than 0.5. 3) Road network density, population density, per capita GDP, and local financial expenditure were significantly correlated with the accessibility of medical and residential care facilities. The average altitude, eco-environmental status index, area, road network density, population density, per capita GDP and public financial expenditure were significantly correlated with the equality of medical and residential care facilities for the elderly in Guangdong Province. The results of this study can provide a reference for optimizing the allocation and layout of medical and residential care facilities in Guangdong Province.