醫療多樣性與空間缺口的研究方法比較：多階段空間資料探勘與兩階段流動搜尋法的評估

Comparative Methods for Medical Diversity and Spatial Gap Analysis: A Multi-Stage Spatial Data Mining and Two-Step Floating Catchment Area Method

本研究旨在評估醫療多樣性與醫療空間缺口，並比較多階段空間資料探勘（Multi-Stage Spatial Data Mining Method，MSDM）和兩階段流動搜尋法（Two-Step Floating Catchment Area Method，2SFCA）兩種研究方法的差異。醫療空間缺口包含橫向（單一層級醫療機構的分布）與縱向（不同醫療層級的服務）資源缺口。醫療多樣性是指人們在選擇垂直醫療機構服務的多樣性，有鑑於其在提高醫療服務品質、可及性和分級醫療的重要性，且過去的研究尚未充分探討，有必要比較兩種方法對多個醫療層級空間覆蓋的結果。研究顯示北北基在醫療空間覆蓋達55~68%，其中以藥局的涵蓋率最低，MSDM所評估的覆蓋面積大於2SFCA（約為20.06~40.52%）。兩種方法的Pearson相關係數與Kappa統計量顯示結果具有六成以上的正相關。兩種方法的主要差異在於其基礎理論不同，2SFCA著重於分析資源供需之間的空間關係及其交互作用，儘管MSDM在空間精度上不如2SFCA，但其在捕捉大量資料、多層次的地理趨勢具有優勢，並補足現階段在垂直醫療評估的缺口。

This study evaluates medical diversity and medical spatial gaps by comparing two research methodologies: Multi-Stage Spatial Data Mining (MSDM) and Two-Step Floating Catchment Area (2SFCA) methods. Medical spatial gaps encompass horizontal resource distribution and vertical disparities based on the different medical levels people seek for various medical needs. Medical diversity refers to the variety of healthcare institutions individuals choose due to their diverse services. Previous research in Taiwan has not sufficiently addressed the assessment of vertical medical resource gaps, so it is crucial to compare the spatial coverage of these methods across multiple medical levels. Both methodologies aim to reveal medical distribution and disparities. The findings indicate that northern Taiwan exhibits a spatial coverage of 55% to 68%, with pharmacies encompassing the lowest coverage. MSDM yields higher medical coverage than 2SFCA, with differences of approximately 20.06% to 40.52% in the coverage area. Pearson correlation coefficients and Kappa statistics show a positive correlation of over sixty percent between the two methods. The primary distinction between these two methods lies in their underlying approaches. 2SFCA primarily examines the spatial relationships between resource supply and demand, focusing on the interplay between these factors. In contrast, MSDM delves into medical diversity in specific locations or regions, capturing vast datasets and identifying intricate geographic patterns and trends. Importantly, MSDM offers insights into the diverse medical tiers in Taiwan, thereby addressing the gaps in vertical medical assessment methodologies.