【摘要】 党的二十大报告指出，要促进优质医疗资源扩容和区域均衡布局。同时，优化首都医疗资源布局也是缓解首都“大城市病”的重要手段。本文基于多循环Acc-Cost模型构建“现状评估-情景模拟-点位优化-格局刻画”的研究框架，对北京市现期医疗资源可达性展开评估，进而多情景分析未来新增医疗资源优化配置方案。研究结果表明：(1)北京市医疗设施可达性以中心城区为峰值点，向外逐级递减，呈现出典型的“中心城区-近郊区-远郊区”圈层式衰减规律。(2)不同情景下优化点位预测状况差异显著，需要研究制定差别化的优化策略。限制增长情景通过182次模型迭代求解出8处新增三甲医院最优点位和174处新增综合医院最优点位，自然趋势情景求解出13处新增三甲医院最优点位和232处新增综合医院最优点位，刺激增长情景求解出21处新增三甲医院最优点位和381处新增综合医院最优点位。(3)“限制增长”情景具有更高的代表性，能够更全面地将自然增长、人口疏解、规划引导等影响因素纳入模型中。在此情景下，模型具备较好的优化效果，可以通过5.6%的新增三甲医院和10.4%的新增综合医院覆盖99%以上医疗资源可达性较差的人群。(4)研究基于限制增长情景下新增医疗点位将北京市全域划分为资源平衡区、资源溢出区和重点优化区，提出北京市全域就医“底线”，打通全域就医“最后一公里”。研究为刻画现实中分级医疗资源优化配置格局提供了理论参考，也为进一步深化公共服务设施优化配置研究提供新的视角和方法。更多还原

【Abstract】 The report of the 20th National Congress of the Communist Party of China pointed out the need to promote the expansion of high-quality medical resources and balanced regional layout. Based on the multi-cycle Acc-Cost model, this paper constructs a research framework of “current situation assessment-scenario simulation-site optimization-pattern characterization” to evaluate the accessibility of medical resources in Beijing and further analyze the optimization and allocation plans for new medical resources under multiple scenarios. The research results indicate that:(1) The accessibility of medical facilities in Beijing peaks in the central urban area and gradually decreases outward, showing a typical “central urban area-suburban area-remote suburban area” concentric decay pattern.(2) The limiting growth scenario identifies 8 optimal sites for new tertiary hospitals and 174 optimal sites for new general hospitals through 182 model iterations, the natural trend scenario identifies 13 optimal sites for new tertiary hospitals and 232 optimal sites for new general hospitals, and the stimulating growth scenario identifies 21 optimal sites for new tertiary hospitals and 381 optimal sites for new general hospitals.(3) The limiting growth scenario is more representative, as it can more comprehensively incorporate factors such as natural growth, population dispersion, and planning guidance into the model. Under this scenario, the model has a good optimization effect, capable of covering more than 99% of the population with poor medical resource accessibility through 5.6% of new tertiary hospitals and 10.4% of new general hospitals.(4) Based on the limiting growth scenario, the study divides the entire area of Beijing into resource balance areas, resource overflow areas, and key optimization areas, proposing a “bottom line” for medical treatment throughout Beijing and facilitating the “last mile” of medical treatment across the entire area. The study provides a theoretical reference for characterizing the optimized allocation pattern of tiered medical resources in reality and offers new perspectives and methods for further research on the optimization and allocation of public service facilities.更多还原