基于熵权TOPSIS和RSR法的我国基层医疗卫生服务能力综合评价  

Comprehensive evaluation of primary health care service capacity in China using entropy weight TOPSIS and RSR

作　　者：潘懿 闫雅洁 丘佳琪 程佳蕙 王全[1] 熊维[2] PAN Yi;YAN Ya-jie;QIU Jia-qi;CHENG Jia-hui;WANG Quan;XIONG Wei(School of Public Health,Wuhan University,Wuhan,Hubei 430072,China;不详)

机构地区：[1]武汉大学公共卫生学院,湖北武汉430072 [2]武汉大学中南医院心内科,湖北武汉430071

出　　处：《现代预防医学》2023年第9期1663-1668,共6页Modern Preventive Medicine

基　　金：健康湖北专项课题项目(JKHB-20-19)。

摘　　要：目的综合评价2020年我国基层医疗卫生服务能力,了解31个省份基层医疗卫生服务能力差异,为实现基层医疗卫生服务能力提质增效、均衡性发展提供参考。方法采用熵权TOPSIS对我国基层医疗卫生服务能力状况进行综合评价,采用多元逐步回归分析影响因素,结合RSR法进行分档。结果2020年31个省份基层卫生服务能力“好”的地区为四川、重庆、湖南、湖北、广西,Ci值分别为0.758、0.742、0.665、0.607、0.603;“差”的地区为北京、天津、宁夏、黑龙江,Ci值分别为0.266、0.298、0.311、0.316。多元逐步分析结果显示,每千人口基层卫生机构数(B=0.182,t=7.264,P<0.001)、床位数(B=0.152,t=2.740,P=0.011)、基层卫生机构医师日均担负诊疗人次(B=0.225,t=7.620,P<0.001)、日均担负住院床日(B=0.905,t=18.279,P<0.001)、基层卫生机构平均住院日(B=0.078,t=3.359,P=0.003)是影响评价结果的主要指标因素。结论我国基层医疗卫生服务能力不高且存在地区性差异,应优化基层医疗卫生机构布局,完善基层设施建设,强化人才保障,加强信息化建设,实现我国基层医疗卫生服务能力整体提升和均衡性发展。Objective To comprehensively evaluate the capacity of primary medical and health services in China in 2020,and to understand the differences in the capacity of primary medical and health services in 31 provinces,so as to provide reference for improving the quality and efficiency of primary medical and health services.Methods Entropy weight TOPSIS was used to comprehensively evaluate the capacity of primary medical and health services in China,and multiple stepwise regression analysis was used to analyze the influencing factors,combined with RSR method for classification.Results In 2020,the areas with“good”primary health service capacity in 31 provinces were Sichuan,Chongqing,Hunan,Hubei,and Guangxi,with Ci values of 0.758,0.742,0.665,0.607,and 0.603,respectively.The“poor”areas were Beijing,Tianjin,Ningxia,and Heilongjiang,with Ci values of 0.266,0.298,0.311,and 0.316,respectively.The multivariate stepwise analysis showed that the number of primary health institutions per 1000 population(B=0.182,t=7.264,P<0.001),the number of beds per 1000 population(B=0.152,t=2.740,P=0.011),the average daily visits per primary health institution physician(B=0.225,t=7.620,P<0.001),the average daily inpatient bed days(B=0.905,t=18.279,P<0.001),and the average length of stay in primary health institution(B=0.078,t=3.359,P=0.003)were the main indicators influencing the evaluation results.Conclusion China’s primary medical and health service capacity is not high and there are regional differences,so we should optimize the layout of primary medical and health institutions,improve the construction of grass-roots facilities,strengthen the guarantee of talents,and strengthen the information construction,to achieve the overall improvement and balanced development of China’s primary medical and health service capacity.

关 键 词：熵权TOPSIS法 RSR法 基层医疗卫生服务能力 

分 类 号：R197.1[医药卫生—卫生事业管理]