中国内地2004-2020年医防融合协调水平发展情况分析  

Trend in coordination for integration of medical treatment and disease prevention in the mainland of China,2004-2020:a statistical data based analysis

作　　者：闫温馨 郭欣 刘霞[3] 梁万年 刘珏[1] YAN Wenxin;GUO Xin;LIU Xia(School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院,北京100191 [2]国家卫生健康委员会体制改革司 [3]中华预防医学会 [4]清华大学万科公共卫生与健康学院

出　　处：《中国公共卫生》2023年第4期472-478,共7页Chinese Journal of Public Health

基　　金：国家自然科学基金优秀青年科学基金项目(72122001);国家自然科学基金重点项目(71934002);国家重点研发计划(2020YFC0846300);全国统计科学中心项目(2021LY038)。

摘　　要：目的了解中国2004-2020年内地31个省(自治区、直辖市)的医防融合协调水平发展情况,为促进新时期健康中国建设的医防融合提供参考建议。方法通过收集2004-2020年《中国卫生健康统计年鉴》和《中国统计年鉴》相关资料,整理衡量医疗系统和公卫系统综合发展水平的相关指标,构建耦合协调模型和中断时间序列模型,检验“新医改”政策对医防融合子系统发展水平及耦合协调程度的瞬时影响和持续影响情况。结果2004—2020年中国内地医疗系统综合发展水平(S_(Y))从2004年的0.560提高至2020年的0.692,各省(自治区、直辖市)S_(Y)从2004年的0.385~0.655提高至2020年的0.524~0.758;中国公卫系统综合发展水平(S_(G))从2004年的0.747提高至2020年的0.875,各省(自治区、直辖市)S_(G)从2004年的0.501~0.846提高至2020年的0.696~0.995。2004—2020年中国内地和各省(自治区、直辖市)医防系统耦合度(C)均>0.9,处于高水平耦合阶段;全国医防融合耦合协调度(D)从2004年的0.805提高至2020年的0.880,各省(自治区、直辖市)D从2004年的0.663~0.852提高至2020年的0.777~0.930。2020年,东部地区S_(Y)为0.573~0.703,S_(G)为0.764~0.901,东部地区S_(Y)和S_(G)均最高。中断时间序列模型分析结果显示,“新医改”政策实行后对多个省(自治区、直辖市)S_(Y)产生了显著的瞬时影响(β_(2)=0.024~0.145,均P<0.05)和持续影响(β_(3)=0.004~0.032,均P<0.05),但对S_(G)的影响不大。结论中国内地2004—2020年医防融合子系统综合发展水平不断提高,医防融合耦合协调程度逐渐加强,但仍存在地区差异。Objective To examine the development of coordination for the integration of medical treatment and disease prevention(treatment-prevention)in 31 provincial level administrative divisions(PLADs)across China during 2004-2020 and to provide a reference for promoting the integration of treatment and prevention in Healthy China construction.Methods Base on the data collected from the China Health Statistical Yearbook and the China Statistical Yearbook of 2004–2020,we compiled relevant indicators for measuring comprehensive development of the medical system and the public health system at national level and PLAD level.We conducted a coupling coordination model analysis and an interrupted time series model analysis(ITSA)to test instantaneous and persistent impact of the“New Medical System Reform Policy”on the development,the degree of coupling,and coordination of the treatment-prevention integration subsystem.Results From 2004 to 2020,the index for comprehensive development of medical system(S_(Y))increased from 0.560 to 0.692 at national level and the S_(Y)also increased for all the PLADs with the ranges from 0.385-0.655 to 0.524-0.758;during the same period,the index for comprehensive development public health system(S_(G))increased from 0.747 to 0.875 at national level and the S_(G)of all the PLADs increased similarly in the ranges from 0.501-0.846 to 0.696-0.995.The range-specific S_(Y)and S_(G)were the highest for the PLADs in eastern China in 2020,with the ranges of 0.573-0.703 for S_(Y)and 0.764-0.901 for S_(G).The results of ITSA showed that the“New Medical System Reform Policy”had a significant transient impact(β_(2)=0.024–0.145,P<0.05)and persistent impact(β_(3)=0.004-0.032,P<0.05)on the development of medical system(S_(Y))in most PLADs,but not on public health system(S_(G)).From 2004 to 2020,the coupling degree(C)of medical system and public health system at national and PLADs level were all above 0.9,indicating a good system coupling.The index(D)for degree of coordination in treatment-prevention

关 键 词：医防融合 协调水平 发展情况 中国内地 

分 类 号：R197[医药卫生—卫生事业管理]