Spatial Optimization and Allocation of Primary Healthcare Facility Resources in Townships and Villages under Different Terrain Conditions of Sichuan Province, China

The first diagnosis at the grassroots level in villages and towns is important in diseases’ prevention and control. Town and village clinics within "three-level rural medical network" are the central bodies to realize the "first diagnosed at grassroots level" of Chinese hierarchical treatment system. Sichuan Province, with rich geomorphological units and varied rural settlement forms, presents significant regional differences in applying the combined configuration standards of “National Medical Institution Setting Plan”. Sichuan’s primary medical facilities with different topography represents the whole country. An important aspect in achieving effective grassroots diagnosis and ensuring the “golden rescue time” is the availability of medical facilities in relation to accessible transportation distance. This paper selects typical towns having different topographical features from the six sub-functional divisions in "Sichuan Ecological Protection and Construction Plan" as research cases. GIS network analysis, neighborhood analysis, ANUSPLIN interpolation, and other research methods were used to examine the accessibility and spatial service patterns of primary medical resources and proposes layout optimization strategies. The results show that: (1) Western Sichuan plateau is characterized by vast area and sparse population with uneven distribution, lacking medical centers. In densely populated eastern basin having smaller area, medical points should be reduced to avoid redundancy, and enhance the internal service capabilities. (2) Significant unbalanced allocation of medical resources exists between the six functional partitions and within partitions. (3) Accessibility of medical facilities in Qiping Town, Luxi Town, and Qinglong Street (eastern basin) is higher than Tangke Town, Heihe Town, and Erliping Town (western plateau area).