Journal of Peking University(Health Sciences) >
Spatial accessibility of fever clinics for multi-tiered prevention and control on COVID-19 in Beijing
Received date: 2021-02-25
Online published: 2021-06-16
Supported by
National Natural Science Foundation of China(71673004);National Natural Science Foundation of China(71911530221)
Objective: To simulate the different prevalence of corona virus disease 2019 (COVID-19) in Beijing as the spreading and the outbreak city and analyze the response capacity of its medical resources of fever clinics, and to provide a scientific basis for optimizing the spatial layout in Beijing under severe epidemics. Methods: The study obtained epidemiological indicators for COVID-19, factors about medical resources and population movement as parameters for the SEIR model and utilized the model to predict the maximum number of infections on a single day at different control levels in Beijing, simulated as an epidemic spreading city and an epidemic outbreak city respectively. The modified two-step floating catchment area method under ArcGIS 10.6 environment was used to analyze spatial accessibility to fever clinics services for the patients in Beijing. Results: According to the results of the SEIR model, the highest number of infections in a single day in Beijing simulated as an epidemic spreading city at low, medium and high levels of prevention and control were 8 514, 183, and 68 cases, the highest number of infections in a single day in Beijing simulated as an outbreak city was 22 803, 10 868 and 3 725 cases, respectively. The following result showed that Beijing was simulated as an epidemic spreading city: among the 585 communities in Beijing, under the low level of prevention and control, there were 17 communities (2.91%) with excellent accessibility to fever clinics, and that of 41 communities (7.01%) with fever clinics was good. Spatial accessibility of fever clinics in 56 communities (9.57%) was ranked average, and 62 communities’ (10.60%) accessibility was fair and 409 communities (69.91%) had poor accessibility; at the medium level of prevention and control, only the west region of Fangshan District and Mentougou District, the north region of Yanqing District, Huairou District and Miyun District had poor accessibility; under the high level of prevention and control, 559 communities’ (95.56%) had excellent accessibility. The accessibility in 24 communities (4.10%) was good and in 2 communities (0.34%) was average. In brief, the existing fever clinics could meet the common demand. Beijing was simulated as an outbreak city: under the low level of prevention and control, only 1 community (0.17%) had excellent accessibility to fever clinics, and 5 communities (0.86%) had good accessibility. The accessibility of fever clinics in 10 communities (1.71%) was average and in 12 communities (2.05%) was fair. The accessibility of fever clinics in 557 communities (95.21%), nearly all areas of Beijing, was poor; under the middle and high level of prevention and control, the accessibility of ecological conservation areas was also relatively poor. Conclusion: The distribution of fever clinic resources in Beijing is uneven. When Beijing is simulated as an epidemic spreading city: under the high level of prevention and control, the number of fever clinics can be appropriately reduced to avoid cross-infection; at the medium level of prevention and control, the fever clinics can basically meet the needs of patients with fever in Beijing, but the accessibility of fever clinics in ecological conservation areas is insufficient, and priority should be given to the construction of fever clinics in public hospitals above the second level in the ecological conservation areas. When the level of prevention and control is low, the accessibility of fever clinics in ecological conservation areas is poor. Priority should be given to the construction of fever clinics in ecological conservation areas, and temporary fever sentinels can be established to relieve the pressure of fever clinics. When Beijing is simulated as an outbreak city and has low prevention and control, due to a large number of infections, it is necessary to upgrade the prevention and control level to reduce the flow of people to curb the development of the epidemic.
Jia-wei ZHANG , Pei-en HAN , Li YANG . Spatial accessibility of fever clinics for multi-tiered prevention and control on COVID-19 in Beijing[J]. Journal of Peking University(Health Sciences), 2021 , 53(3) : 543 -548 . DOI: 10.19723/j.issn.1671-167X.2021.03.017
| [1] | 陈慧, 姜淮芜, 刘静梅. 传染病定点医院新冠肺炎疫情期间发热门诊分区分级接诊策略[J]. 寄生虫病与感染性疾病, 2020,18(3):141-144. |
| [2] | Noll NB, Aksamentov I, Druelle V, et al. COVID-19 scenarios: an interactive tool to explore the spread and associated morbidity and mortality of SARS-CoV-2[J]. (2020-05-12)[2020-12-20]. https://doi.org/10.1101/2020.05.05.20091363. |
| [3] | Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia[J]. N Engl J Med, 2020,382(13):1199-1207. |
| [4] | 中国疾病预防控制中心. 新型冠状病毒肺炎流行病学特征分析[J]. 中华流行病学杂志, 2020,41(2):145-151. |
| [5] | Yang Y, Lu QB, Liu MJ, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China[J]. (2020-02-21)[2020-11-21]. https://doi.org/10.1101/2020.02.10.20021675 |
| [6] | Qin J, You C, Lin Q, et al. Estimation of incubation period distribution of COVID-19 using disease onset forward time: A novel cross-sectional and forward follow-up study[J]. Sci Adv, 2020,6(33):1202. |
| [7] | Pan A, Liu L, Wang C, et al. Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China[J]. JAMA, 2020,323(19):1915-1923. |
| [8] | Wang F. Why public health needs GIS: a methodological overview[J]. Ann GIS, 2020,26(1):1-12. |
| [9] | Mcgrail MR. Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements[J]. Int J Health Geogr, 2012,11:50. |
| [10] | Luo W, Qi Y. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians[J]. Health Place, 2009,15(4):1100-1107. |
| [11] | 陶卓霖, 程杨. 两步移动搜寻法及其扩展形式研究进展[J]. 地理科学进展, 2016,35(5):589-599. |
| [12] | Wang X, Yang H, Duan Z, et al. Spatial accessibility of primary health care in China: a case study in Sichuan Province[J]. Soc Sci Med, 2018,209:14-24. |
| [13] | Wang X, Pan J. Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China[J]. BMC Health Serv Res, 2016,16(1):399. |
| [14] | Vadrevu L, Kanjilal B. Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA): a case study of the Indian Sundarbans[J]. Int J Equity Health, 2016,15(1):87. |
| [15] | Nakamura T, Nakamura A, Mukuda K, et al. Potential accessibi-lity scores for hospital care in a province of Japan: GIS-based ecological study of the two-step floating catchment area method and the number of neighborhood hospitals[J]. BMC Health Serv Res, 2017,17(1):438. |
| [16] | Tao Z, Cheng Y, Zheng Q, et al. Measuring spatial accessibility to healthcare services with constraint of administrative boundary: a case study of Yanqing District, Beijing, China[J]. Int J Equity Health, 2018,17(1):7. |
| [17] | 陶卓霖, 程杨, 戴特奇, 等. 公共服务设施布局优化模型研究进展与展望[J]. 城市规划, 2019,43(8):60-68, 88. |
| [18] | 程敏, 黄维维. 基于高斯两步移动搜索法的上海市养老设施空间可达性评价[J]. 复旦学报(自然科学版), 2020,59(2):129-136. |
| [19] | Cheng G, Zeng X, Duan L, et al. Spatial difference analysis for accessibility to high level hospitals based on travel time in Shenzhen, China[J]. Habitat Int, 2016,53:485-494. |
| [20] | Peeters D, Thomas I. Distance predicting functions and applied location-allocation models[J]. J Geogr Syst, 2000,2(2):167-184. |
| [21] | Siegel M, Koller D, Vogt V, et al. Developing a composite index of spatial accessibility across different health care sectors: A German example[J]. Health Policy, 2016,120(2):205-212. |
| [22] | 中共北京市委办公厅, 北京市人民政府办公厅. 关于印发《加强首都公共卫生应急管理体系建设三年行动计划(2020—2022年)》的通知[J]. 北京市人民政府公报, 2020(32):26-47. |
| [23] | 左克强, 金逸, 焦岳龙, 等. 新冠肺炎疫情后发热门诊及门急诊诊疗流程优化之策[J]. 中国医院院长, 2020,16(21):81-83. |
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