医疗设施因其级别、规模的不同，在医疗服务体系中承担的分工也不同。在分工明确的医疗服务体系下将医疗设施进行均衡性布局，不仅能促进医疗设施的有效利用，更能在一定程度上缓解“看病难”的境况。 本文探讨了医疗设施均衡性布局的原理和方法，指出公平性和效率性是规划布局的两个基本要素。以北京市城六区为研究对象，针对其发展二级医疗体系的要求，从地理空间分布的角度，将医疗设施的“供”与居民点的“需”结合起来，引进地理信息系统（GIS），运用地理可达性、泰森多边形等分析方法，分析了二级医疗设施空间布局特征与存在问题，为进一步完善二级医疗体系提供调整依据。 首先对研究区内的社区卫生服务机构、三级医院及居民点进行空间分布分析，描述布局特征，找出存在问题及影响因素。其次在均衡性布局分析中，先使用了基于地理可达性的公平性分析法，分别评价了社区卫生服务机构、三级医院这些医疗设施对患者就医的公平性。然后根据泰森多边形原理，为二级医疗服务体系下的每个医疗设施进行服务区划分及服务人口分析，对比实际门诊量，分别得到社区卫生服务机构和三级医院的效率性评价。最后总结均衡性评价结果，据此提出二级医院的转型建议以及完善二级医疗服务体系的对策。 本文认为：在二级医疗体系的构建上，基层卫生服务机构的建设已经相对饱和，其公平性体现的较好，但是效率性较差。现有的三级医院虽总量足，但分布不均，导致公平性略差于基层卫生服务机构，效率性存在两级分化的现象。且部分医院已经成为国家级医疗中心，不能全部作为区域医疗中心进行规划布局，必须将二级医院补充进来，承担区域医疗中心的任务。 本文的研究成果将对我国医疗服务设施空间布局以及医疗服务市场资源配置的高效化合理化提供参考和借鉴，同时也对研究公共服务设施均衡性提供研究方法上的探究。

As a result of different grades and scales, health facilities have different functions in health service system. Under the health service system with a clear division of labor, balanced layout of health facilities could promote effective utilization of health facilities as well as relieving the circumstance of “difficult medical treatment” to a certain extent. After discussing the principles and methods of balanced layout of health facilities, this study pointed out that fairness and efficiency were two basic elements of planning layout. The object of this study was central six districts of Beijing, aiming at the developing requirement of two grade health system, combing the supply of health facilities and demand of residential areas from the perspective of geographic spatial distribution. In order to provide the adjusting basis for improving two grade health system, this study analyzed the problems of space layout features and existence with the use of Geographic Information System(GIS) and other analytic techniques such as geographic accessibility, Thiessen-polygon, etc. At first, this study analyzed the space layout of community health service institutions, three grade hospitals and residential areas in the study area, described the layout features and found out the existing problems and influencing factors. Secondly, for analyzing balanced layout, this study used fairness analysis method based on geographic accessibility to assess the fairness of patients in community health service institutions and three grade hospitals. And then, according to Thiessen-polygon principle, this study divided service areas, analyses service populations and compared actual outpatient amounts for every health facility under two grade health service system, obtaining the efficiency evaluation results of community health service institutions and three grade hospitals. At last, based on the results of balance evaluation, this study proposed transformation suggestions for two grade hospitals and solutions for improving two grade health service system.The conclusions are as follows: under the two grade health service system, the construction of primary health services is relatively saturated, its fairness embodied better, but the efficiency is poor. Existing tertiary hospitals, although the total amount is enough, but the distribution is uneven, leading to fair slightly worse than the grass-roots health services, the efficiency of the existence of the phenomenon of polarization. And part of the hospital has become a national medical center, not all as a regional medical center planning and layout must be added in secondary hospitals to undertake the tasks of the Regional Medical Center. This study can provide information and recommendations to local government or planning decision-makers, and provide the scientific basis for selecting the best allocation of resources to promote rational development of medical facilities layout.