摘要
[目的]以分级诊疗政策推进为切入点,分析2012-2021年我国基层卫生资源配置情况,为政府制定针对性的空间干预政策及优化基层卫生资源配置提供参考。[方法]运用基尼系数从整体上分析基层卫生资源配置公平性,再以分级诊疗政策为切入点,重点研究2015年、2018年和2021年3个时间节点基层卫生资源区域配置公平性及空间分布情况。[结果]在研究期间,我国基层医疗卫生机构数、床位数和卫生技术人员数的年均增长率分别为0.77%、2.81%和5.43%。按人口分布,床位和卫生技术人员的基尼系数均低于0.2,医疗卫生机构基尼系数在0.1848~0.2020波动,公平性较好;按地理面积分布,3个指标的基尼系数均超过0.5,公平性较差。空间分布上,医疗卫生机构和床位的全局Moran's I指数均大于0,提示卫生物力资源存在空间正相关,呈空间聚集分布;卫生技术人员的Moran's I指数为负,空间自相关性不显著。局部空间自相关结果显示,分级诊疗实施后我国基层卫生资源在地区间主要呈东中西部差异化分布,各项卫生资源空间分布不均衡。[结论]我国基层卫生资源呈增长趋势,人口分布上较为公平,但地理分布的不平等和资源聚集现象仍然显著。建议政府考虑人口和地理分布的差异性,优化卫生资源配置,增强区域内医疗机构沟通与协作。
Objective Taking the promotion of tiered diagnosis and treatment policy as the starting point,this paper analyzes the allocation of primary health resources in China from 2012 to 2021 to provide the reference for the government to formulate targeted spatial intervention policies and optimize the allocation of primary health resources.Methods The Gini coefficient was used to analyze the equity of allocation of primary health resources as a whole.Then the tiered diagnosis and treatment policy was taken as the starting point to study the equity and spatial distribution of regional allocation of primary health resources in 2015,2018 and 2021.Results During the study,the average annual growth rates of the number of primary medical and health institutions,the number of beds and the number of health technicians were 0.77%,2.81%and 5.43%,respectively.According to the population distribution,the Gini coefficients of beds and health technicians were both lower than 0.2,and the Gini coefficient of medical and health institutions fluctuated between 0.1848 and 0.2020,indicating good equity;according to geographical area distribution,the Gini coefficients of the three indicators were all greater than 0.5,indicating poor equity.In terms of spatial distribution,the global Moran's I index of medical and health institutions and beds were greater than 0,indicating that there was a positive spatial autocorrelation of health material resources and a spatial aggregation distribution.The Moran's I index of health technicians was negative,with no significant spatial autocorrelation.The results of local spatial autocorrelation showed that the primary health resources in China were differentiated distribution in the eastern,central and western regions after the implementation of tiered diagnosis and treatment.The spatial distribution of various health resources was unbalanced.Conclusions The primary health resources in China show an increasing trend,and the population distribution is relatively equitable,but the inequality of geographical
作者
陈小璐
刘婷
盘薇
CHEN Xiaolu;LIU Ting;PAN Wei(School of Information and Management,Guangxi Medical University,Nanning Guangxi 530021,China;School of Basic Medical Sciences,Guangxi Medical University,Nanning Guangxi 530021,China)
出处
《卫生软科学》
2024年第8期13-17,22,共6页
Soft Science of Health
基金
国家自然科学基金(11902083)。
关键词
基层卫生资源
公平性
空间分布
分级诊疗
primary health resources
equity
spatial distribution
tiered diagnosis and treatment
