知识溢出视角下的卫生资源配置空间聚集与卫生总费用影响因素研究  

Study on the Influencing Factors of the Spatial Agglomeration of Health Resources Allocation and Total Health Expenditure from the Perspective of Knowledge Spillover

作　　者：陈燕莹 吴睿[1,2] 朱黎明 路伟 CHEN Yan-ying;WU Rui;ZHU Li-ming(School of Management,Hainan Medical University,Haikou,571199,China)

机构地区：[1]海南医学院管理学院,海口571199 [2]杭州师范大学医学部公共卫生学院,杭州311121 [3]中国人民大学商学院,北京100872

出　　处：《中国卫生经济》2022年第7期47-49,59,共4页Chinese Health Economics

基　　金：海南省人文医学研究基地项目(QRYZH201802(YB));海南医学院科研课题(HYPY201929)。

摘　　要：目的:分析我国各省份卫生资源配置空间聚集效应与卫生总费用的关系,度量不同指标维度对卫生总费用的影响。方法:运用空间滞后模型分析卫生资源配置对卫生总费用增长的影响作用。结果:卫生总费用的增长不仅受到医疗人力资源、服务设施、服务投入、服务需求和知识溢出的正向影响,也会受到来自邻近地区卫生总费用增长的正向影响,而良好的护理人力资源配置能够缓解卫生总费用的增长。结论:建议对核心聚集区域进行新兴医疗技术的成本效益分析和医疗效用一致性评价,而对承接知识溢出的邻近地区尽快将前沿技术成熟化和规模化,坚持分级诊疗和医保控费,提倡全健康因素干预的理念,将卫生政策保障引向多部门协作的多元治理模式。Objective:To analyze the relationship between the spatial agglomeration effect of health resources allocation and the total health expenditure(THE)in order to explore the effects of different dimensions on THE.Methods:The spatial lag model is used to analyze the effect of health resource allocation on the increase of total health expenditure.Results:The growth of total health expenditure is positively affected not only by the commitment of human resources,service facilities,service demand and knowledge spillover,but also by the growth of THE from neighboring areas.Good allocation of nursing human resources could alleviate the growth of THE.Conclusion:It is recommended that new medical technology for core accumulation areas were estimated by cost-benefit analysis and medical utility consistency evaluation,while neighboring areas that receive knowledge spillovers mature and scale up cutting-edge technologies as soon as possible.It is needed to insist on graded treatment and health insurance cost control,promote the concept of whole health factor intervention,and lead health policy protection to a multi-sectorial collaborative and multi-governance model.

关 键 词：卫生资源配置 空间聚集效应 卫生总费用 空间滞后模型 知识溢出 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F207[经济管理—国民经济]