摘要
[目的]了解广西卫生人力资源市场结构情况,探索广西卫生人力资源的竞争态势及其与医疗费用之间的关系,为合理配置卫生人力资源和控制医疗费用提供决策参考。[方法]基于HHI指数、市场分散度(1/HHI)描述卫生人力资源的竞争态势及市场竞争强度;运用Welch ANOVA检验分析GDP水平不同的地域之间卫生人力资源分布的差异;采用Wilcoxon符号秩和检验分析卫生人力资源分布与市场规模实力及人口规模的关系;通过Spearman相关分析探索市场分散度与医疗费用之间的关系。[结果]医师、护士资源的HHI最大值分别为0.1122、0.1063,最小值分别为0.1019、0.1032,均属于寡占型中低寡占Ⅱ型市场结构;各地市两种卫生人力资源市场分散度(1/HHI)值较接近,基本保持在8~10,小于标准值14,市场结构还不够完善;医师资源市场分散度与医疗费用的相关系数为-0.627(P<0.05),护士资源市场分散度与医疗费用的相关系数为-0.126(P>0.05)。[结论]卫生人力资源更多集中于经济规模实力宏厚及人口规模大的地市,虹吸现象显著;医疗费用控制效果欠佳,卫生人力资源竞争不充分加剧了这一情况;医疗服务市场结构不合理,区域间卫生人力资源分布的差异较明显。建议政府及相关部门应优化卫生人力资源配置、加大医疗费用控制力度、完善医疗服务市场建设。
Objective To know market structure of health human resources in Guangxi,explore the relationship of competitive situation of health human resources and its medical expenses so as to provide decision-making reference for rational allocation of health human resources and control of medical expenses.Methods Based on HHI index and market dispersity(1/HHI)value,described market competition intensity and competition situation of health human resources.It used Welch ANOVA test to analyze the difference of health human resource distribution among different GDP levels regions.It adopted Wilcoxon symbol rank sum test to analyze the relationship of the distribution of health human resources and market and population size.It explored the relationship between market dispersal and medical expenses through Spearman correlation analysis.Results The maximum HHI values of physicians and nurses was 0.1122 and 0.1063,respectively,and the minimum values was 0.1019 and 0.1032,respectively.All of them were oligopolistic medium-low oligopoly type II market structure.The dispersity(1/HHI)value of two kinds health human resources market in prefectures and cities was relatively close,basically maintained between 8 and 10,less than the standard value of 14,the market structure was not perfect.The correlation coefficient between physician resource market dispersion and medical expenses was-0.627(P<0.05),the correlation coefficient between nurse resources market and medical expenses was-0.126(P>0.05).Conclusions The health human resources are more concentrated in the cities with large economies and large population.The siphon phenomenon is remarkable.The medical cost control effect is not good,and the lack of health human resources competition has aggravated this situation.The medical service market structure is not reasonable,the difference in the distribution of health human resources among regions is more obvious.It is suggested that the government and relevant departments should optimize the allocation of health human resources,increase t
作者
崔笛儿
吴利忠
霍海英
CUI Di-er;WU Li-zhong;HUO Hai-ying(School of information and management,Guangxi Medical University,Nanning Guangxi 530021,China;Affiliated Stomatological Hospital of Guangxi Medical University,Nanning Guangxi 530021,China)
出处
《卫生软科学》
2020年第12期17-21,36,共6页
Soft Science of Health
基金
国家自然科学基金-广西公立医院改制重组模式及其优化路径的研究(81560555)
基于ESCP范式的广西公立医院改制效果评估与政策研究(71964004)。
