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要旨
目的:高知県を対象に地理情報システムを用いて,訪問看護ステーション(VNS)のサービス提供体制別にみた空間アクセシビリティの評価を目的とする.
方法:オープンデータを用いてVNSのサービス提供体制の分布を求めた.VNS の空間分布と自動車の法定速度で,30分で到達可能な勢力範囲を割り出した.
結果:最寄りのVNSまでの直線距離の平均は2,199.8m,最短が623.1m,最長が6,793.5mだった.全てのVNSの勢力範囲とサービス提供体制別の勢力範囲の比較では,24時間対応,緊急対応,精神看護で一部空白区域があったが,概ね30分の勢力範囲をカバーしていた.リハビリ専門職が配置されたVNSの勢力範囲において,西部の沿岸部に空白区域が認められた.
結論:VNSの偏在による空間アクセシビリティの不公平性に対して,人口やVNSの報酬体系,移動距離,地理的特徴を考慮したソリューションの検討が必要である.
Purpose: To evaluate the use of a geographic information system to assess the spatial accessibility of visiting nursing stations (VNSs) and highlight the uneven distribution of VNSs and gaps in service delivery.
Methods: We calculated the distribution of VNS service provision systems using open data. Specifically, we estimated the spatial distribution of VNSs and service areas that could be reached in 30 minutes by car at the legal speed limit.
Results: The average straight-line distance to the nearest VNS was 2,199.8 m, and the shortest and longest distances were 623.1 m and 6,793.5 m, respectively. A review of the service areas of all VNSs by service type indicated that they included almost all services, although blank areas existed in 24-hour response, emergency response, and psychiatric nursing. Among VNS service areas staffed by rehabilitation staff, a blank area was observed on the western coast.
Conclusion: To address inequalities in the spatial accessibility of VNSs, solutions must consider regional populations, VNS payment systems, travel distances, and geographical features.
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