| 摘要: | 醫療設施作為患者與醫事人員的交互空間，在維護生活質量與改善社會福利中扮演重要的角色。近年來隨著人口結構高齡化，長者在城市中使用公共交通 (Public Transit, PT) 的醫療易達性成為新興研究。然而，過往研究主要聚焦於單一交通模式易達性的空間度量，較少考慮多模式易達性，以及加入非空間因素，包含資源需求、經濟弱勢、文化弱勢，所導致醫療服務的空間不平等與差異。因此，本研究選定臺北市作為研究區，以多模式兩階段流動搜尋法為基底，加入非空間因素計算交通醫療易達性，再利用公平性指標與傳統單模式進行比較。量測易達性的需求面為長者數，供給面為全科醫師表示，移動時間係藉由路網分析估算，將私有運具、公共運輸、步行分別以30、20、10分鐘作為搜尋範圍，探索臺北市存在空間不平等的區域，討論空間群聚以及空間相關性分析。結果表明，臺北醫療易達性具有空間異質性，空間群聚於市中心與內湖一帶，且移動模式以私有運具佔有優勢，再者，加入非空間因素結果表示高需求以及弱勢族群享有更好的易達性，代表政府有比較好的照顧這些人使用醫療資源。本研究相信此方法可以為政府與交通規劃師提供確據，以制定更完整的政策促進更加友善的社會。
Spatial accessibility to healthcare facilities has become a significant focus in health geography research in recent years. However, previous studies have primarily focused on spatial measurements of accessibility for a single transport mode, neglecting the impact of multimodal transport and non-spatial factors that contribute to spatial inequalities and disparities in healthcare services. In this study, we selected Taipei as the research area and aimed to propose an enhanced multi-modal two-step floating catchment area (2SFCA) for measuring healthcare accessibility. The proposed method integrates spatial and non-spatial factors, such as resource needs, economic vulnerability, and cultural vulnerability. To represent the demand side of accessibility, we used the number of elderly populations, while the distribution of general practitioners represented the supply side. Travel times were estimated through network analysis, considering driving, public transit, and walking, with catchment areas of 30, 20, and 10 minutes, respectively. We compared the proposed method with the traditional single-mode model using spatial analysis and equity indicators. The results indicate that healthcare accessibility in Taipei exhibits spatial heterogeneity, with spatial clustering observed in the city center and Neihu district. Additionally, driving is the dominant mode of transportation over public transit. Moreover, the incorporation of non-spatial factors reveals that areas with high demand and vulnerable populations experience better accessibility, suggesting that the government provides better support in accessing medical resources. This study believes that our approach can provide evidence for the government and transportation planners to enact more comprehensive policies and promote a more friendly society, ensuring equitable access to healthcare resources. |
