摘要
背景随着中国传统医学纳入国际疾病分类第十一次修订本(ICD-11)编码,基层中医医疗资源的合理配置是推动中西医融合和优质医疗资源全民覆盖的保障。基层医疗机构布局和服务能力不均衡,导致城市乡镇地区普遍存在医疗资源供需错位问题。目的了解我国乡镇中医药服务开展状况,科学评价基层中医药诊疗的覆盖范围和服务可及性,为优化基层中医药服务空间资源配置提供新思路并据此提出优化策略。方法基于第七次全国人口普查数据和点状地理空间数据,引入医疗服务半径概念来计算步行模式下不同层级中医类医疗机构的诊疗范围。采用空间核密度指数、空间标准差椭圆等方法揭示中医类医疗服务供需能力的空间公平性。基于以上结果提出中医类医疗资源布局优化类型及措施。结果截至2022年增城区共计医疗机构699家,其中带有床位的中医类医疗机构18家,不同乡镇、街道的中医类医疗机构床位分布呈现出较大的差异。中滩镇千人口床位数为14.31张,在所有街道中排在第一位。永宁街道千人口床位数排在末位,仅为0.89张。增城区中医类医疗机构呈现出明显的双中心格局,中新镇中部、派潭镇北部和石滩镇西南部居民的中医药服务可获得性较弱。不同乡镇的中医药服务供给能力差别较大,中医类医疗机构空间分布同城镇居民的整体空间聚集程度还存在一定程度的不吻合,不同乡镇间的中医药服务半径存在差异。结论中医药发展战略实施以来,中国传统医学得到了保护和发展。应当采取更为科学的策略将中医药服务同城市发展和居民需求紧密结合,积极采取增加设施点、资源转移和下沉相结合、跨区域的中医药信息化联合诊疗的差异化策略,逐步实现真正意义上的全覆盖和中西医并重的战略。
Background As China's Traditional medicine is included in the ICD-11 code,the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources.The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas.Objective Understand the development status of traditional Chinese medicine services in rural areas of China,scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment,provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services,and propose optimization strategies accordingly.Methods Based on the seventh national population census data and path planning data,the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode.Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services.Based on the above results,propose types and measures for optimizing the layout of traditional Chinese medicine medical resources.Results As of 2022,there are a total of 699 medical institutions in Zengcheng District,including 18 traditional Chinese medicine medical institutions with beds.There were significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets.Meanwhile,the number of beds per thousand population in Zhongtan Town was 14.31,ranking first among all streets.The number of beds per thousand people in Yongning Street ranks last,with only 0.89 beds.Traditional Chinese medicine medical institutions in Zengche
作者
李成程
周尚成
贺凯玥
刘爱玲
梁珊珊
高婧
钟艾霖
LI Chengcheng;ZHOU Shangcheng;HE Kaiyue;LIU Ailing;LIANG Shanshan;GAO Jing;ZHONG Ailin(School ofPublic Health and Management,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)
出处
《中国全科医学》
CAS
北大核心
2025年第2期234-241,共8页
Chinese General Practice
基金
国家自然科学基金资助项目(71774079,81973979)
广东省自然科学基金资助项目(2019A1515011496)
广东省社科基金项目(GD19CSH04)。
关键词
中医医疗机构
医疗服务半径
基层中医药服务
空间标准差椭圆
空间优化
Medical organizations(TCM)
Medical service radius
Grassroots traditional Chinese medicine services
Spatial standard deviation ellipse
Space optimization
