広島県における医療施設の最適立地
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概要
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It is desirable that public facilities are utilized by every inhabitant in the region. The construction of public facilities is financially limited in number, so that facilities tend to be located in a center with large accessibility. It means that such a location minimizes the sum of effects of visiting the facility for all inhabitants. Accordingly linear programming (LP) may be effectively used as the procedure for the determination of the location of public facilities. LP described here implies trasportation problem, Weberian location problem and location-allocation problem.In this paper the author deals with location problems of the medical facilities which are among the most important public facilities. It is based on that accessibility plays an important roll for the location of medical facilities because they are usually used by sick and wounded persons. It is considered, however, that the outpatient behaves differently to the medical care from the inpatient. In this connection they are treated respectively.Although medical facilities in Hiroshima prefecture are fairly complete both in quality and quantity, the regional imbalance seems to exist in demand and supply of medical services; many facilities are concentrated in urban areas, especially in Hiroshima city. While Hiroshima city has medical function of high level and also a broad health service area, there are some rural communities which lack doctor. Under such imbalanced distribution of medical facilities, the ratio of patients serviced by the facility within their own community to all patients of that community is fairly different from community to community. Generally speaking the ratio is higher for outpatients than for inpatients.For using LP the author firstly constructs the network of communities and traffic routes which constitute nodes and links respectively. The nodes are divided into origins and destinations according to the difference between the number of dwelling patients and that of accomodated patients. The links may be measured by the time-distance from dwelling community to facility place.Transportation problem is applied to the network and the optimal solution is obtained. The actual pattern of patient behavior fits more significantly the pattern of the optimal solution in the case of outpatients than that of inpatients. This means that the behavior of outpatients is affected by the distance factor. Then the sensitivity analysis may be added to this solution. This analysis is used to obtain the optimal pattern of patient flow that decrease in the value of objective function of the solution. In this analysis the parameter which changes the value may be the number of accomodated patient (accomodating capacity).It may safely be concluded through the analysis above that more medical facilities may preferably be located in Kake-cho and Yoshida-cho in Geihoku area. This result can be regarded as the optimal location of the medical facilities.In this paper due to the restriction on the data the author had to treat all patients and medical facilities without paying attention to the difference of particular department of medicine. That is a problem for the analysis based on demand and supply for medical service. The propriety of transportation problem as the model has to be examined, and as the figure of accessibility, more proper one may be needed. The author hopes to investigate further to solve these problems.
- 人文地理学会の論文