2005-2017年重庆市卫生人力资源配置时空差异分析  

The Spatial-temporal Pattern Analysis of Health Human Resources Allocation Differences in Chongqing Between 2005 and 2017

作　　者：孟秋雨 张燕 刘勋 文童 马阳 MENG Qiu-yu(School of Public Health and Management,Chongqing Medical University,Research Center for Medicine and Social Development,Innovation Center for Social Risk Governance in Health,Chongqing,P.R.China)

机构地区：[1]重庆医科大学公共卫生与管理学院.医学与社会发展研究中心 健康领域社会风险预测治理协同创新中心,重庆400016

出　　处：《中国卫生事业管理》2020年第5期359-363,391,共6页Chinese Health Service Management

基　　金：重庆市社会科学规划项目“统筹城乡重庆市医疗卫生资源配置公平性与利用效率研究”(2013QNGL50);重庆市卫生局医学科研计划项目“重庆市医疗卫生资源配置公平性及利用效率研究”(2013-2-153).

摘　　要：目的:分析2005~2017年重庆市卫生人力资源配置的地区差异与空间分布格局,为优化卫生人力资源配置提供科学依据。方法:运用基尼系数与泰尔指数测量卫生人力资源配置地区差异,采用探索性空间数据分析方法分析卫生人力资源配置差异的空间分布格局及演变态势。结果:2005~2017年重庆市每千人口拥有的卫生人力资源数量逐年增加;各指标基尼系数与泰尔指数整体呈下降趋势,以2009~2013年尤为显著,区域间差异是引起卫生人力资源分布不均的主要原因。卫生人力资源呈空间正相关分布,各指标全局莫兰指数随年份呈现先降后升趋势,热点区域较恒定的位于经济水平较好的主城区,冷点区域主要集中在渝东南和渝东北的边远地区。结论:新医改促进了重庆市卫生人力资源的优化配置,地区分布差异缩小,空间聚集性下降,但区域间差异仍占主导地位,近年卫生人力资源分布差异有反弹趋势,建议强化政府主导责任,制定科学、合理的卫生人力政策和规划,重点关注执业医师等高质量卫生人员的配置,加大对渝东南和渝东北边远地区的投入和扶持力度,努力缩小地区差异,推动区域协调发展。Objective To analyze the regional differences and spatial patterns of the allocation of health human resources in Chongqing between 2005 and 2017,and to provide scientific evidence for optimizing the allocation of health human resources.Methods The Gini coefficient and the Theil index were used to measure the differences in the allocation of health human resources.The exploratory spatial data analysis was used to analyze the spatial pattern of the differences in the allocation of health human resources.Results The number of health human resources per 1,000 population in Chongqing increased between 2005 and 2017 year by year and the Gini coefficient as well as the Theil index,especially from 2009 to 2013,presented a downward trend.The inter-regional difference was the main reason for the maldistribution of health human resources.The distribution of health human resources showed positive spatial correlation,and Global Moran’s I indexes of all indicators decreased firstly,then increased by time pasted.The hot spots were constantly located in the main urban areas with higher economic level,and the cold spots were mainly aggregated in the remote areas in the southeast and northeast of Chongqing.Conclusions The new health care reform has promoted the optimization of health human resources allocation in Chongqing.The inter-regional differences have been narrowed and the spatial clustering has declined,while the regional differences is still playing a dominant role.The spatial differentiation of health human resources has a rebound trend in recent years.Therefore,it is recommended to strengthen the leading responsibility of the government and formulate scientific and rational policies and plans for health human resources.We should also focus on the allocation of high-quality health workforce such as medical practitioner and increase investment and support for the remote areas in southeast and northeast of Chongqing,thus reducing regional disparities and promoting the balanced development among regions.

关 键 词：卫生人力资源 基尼系数 泰尔指数 探索性空间数据分析 

分 类 号：R197[医药卫生—卫生事业管理]