基于聚类分析的全国医共体试点县分类指导方法与实践  

Classification and Practice of Pilot Counties in China’s Medical Community Based on Cluster Analysis

作　　者：陆增辉[1] 陈艳宁[1] 黄二丹 江蒙喜 农圣[1] LU Zeng-hui;CHEN Yan-ning;HUANG Er-dan(Youjiang Medical University for Nationalities,Baise,Guangxi,533000,China;不详)

机构地区：[1]右江民族医学院,广西百色533000 [2]国家卫健委卫生发展研究中心,北京100031

出　　处：《中国卫生经济》2022年第2期39-43,共5页Chinese Health Economics

基　　金：国家自然科学基金项目(72164036);广西教育厅研究生教育创新计划项目(JGY2021213)。

摘　　要：目的:以关键因素对各医共体试点县实施聚类分析,提高医共体运行结果评价的公平性和政策指导的针对性。方法:以2020年全国医共体试点县数据为例,归纳影响医共体运行的关键因素,实施K均值聚类分析后将分组平均值和组内排名向各县反馈,提供针对性的改革建议。结果:人口密度、交通成本和医保筹资3个因素将医共体试点县划分为空间中分布区域不同的8个组,社会经济特征相似的县被分到了同一组,数据较极端的县域被单独提出成组,避免了均值受异常值的影响,提高了组内数据的可比性和分类指导的可行性。结论:基于聚类分组的信息反馈能提高政策评价的公平性和分类指导的精准度,不同县域医共体改革应探索因地制宜、差异互补的发展模式,医共体应着眼于提供全局性、全链条、囊括软性硬性的健康服务。Objective:Cluster analysis is performed on the pilot counties of the medical community based on key factors to improve the equity of the evaluation of medical community and the pertinence of policy guidance.Methods:Taking the data of pilot counties of the national medical community in 2020 as an example,the key factors affecting the operation of the medical community are summarized.After K-means clustering analysis is carried out,the group average and intra-group ranking are fed back to each county to provide targeted reform suggestions.Results:According to the three factors,the pilot counties of medical communities are divided into 8 clusters with different distribution areas in the space.The counties with similar socio-economic characteristics are grouped into the same group.The counties with more extreme data are separately grouped into groups to avoid the influence of outliers on the mean value and improve the comparability of data within the group and the feasibility of classification guidance.Conclusion:Clustering grouping-based information feedback can improve the fairness of policy evaluation and the accuracy of classified guidance.The reform of different county medical community should explore the development mode of adjusting measures to local conditions and complementing differences,and the medical community should focus on providing global,whole chain,including soft and hard health services.

关 键 词：医疗共同体 试点县 指导方法 聚类分析 

分 类 号：R1-0[医药卫生—公共卫生与预防医学] R197.62