分级诊疗视角下我国卫生资源配置均衡性研究  

A study on the balance of health resource allocation in China from the perspective of hierarchical diagnosis and treatment

作　　者：曹楠 王志伟[1] 杨欣维 宁皓 常慧 CAO Nan;WANG Zhiwei;YANG Xinwei;NING Hao;CHANG Hui(School of Management,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学管理学院,北京100029

出　　处：《卫生软科学》2023年第7期23-29,共7页Soft Science of Health

摘　　要：[目的]分析分级诊疗制度实行以来我国医院和基层医疗卫生机构卫生资源配置均衡现状及变动情况,为合理优化卫生资源配置提供参考。[方法]从人力资源和物力资源2个维度对我国31个省份2015-2020年卫生资源配置现状进行统计描述;利用基尼系数、泰尔指数对卫生资源配置均衡性进行评价。[结果]2015-2020年,我国医疗卫生机构数、床位数、卫生技术人员数、执业(助理)医师数和注册护士数的年均增长率分别为4.01%、29.73%、33.35%、34.44%和37.13%,医院各类卫生资源的年均增长率为28.30%、33.78%、33.59%、34.84%和40.74%;基层医疗卫生机构的各类卫生资源的年均增长率为5.35%、16.66%、38.37%、39.43%和63.53%。按人口分布的基尼系数处于0.3以下;按地理分布的基尼系数处于0.7左右。泰尔指数结果呈逐年下降趋势,区域内资源配置差异贡献率达到80%左右。[结论]分级诊疗实施后,我国各类卫生资源配置的均衡性总体改善,但倒三角配置格局仍然较为突出,东部地区资源配置失衡现象最为凸显,地理分布均衡性仍需引起重视。Objective To analyze the current status and changes of health resource allocation in hospitals and primary health care institutions in China since the implementation of hierarchical diagnosis and treatment system,so as to provide a basis for optimizing health resource allocation reasonably.Methods The status quo of health resource allocation in China from 2015 to 2020 was statistically described from human resources and material resources.The Gini coefficient and the Theil index were used to measure the balance of health resource allocation.Results From 2015 to 2020,the average annual growth rates of the number of medical institutions,the number of beds,the number of health technicians,the number of licensed(assistant)physicians and the number of registered nurses were 4.01%,29.73%,33.35%,34.44%and 37.13% respectively.The average annual growth rates of various health resources in hospitals were 28.30%,33.78%,33.59%,34.84% and 40.74%.The average annual growth rates of various health resources in primary medical and health institutions were 5.35%,16.66%,38.37%,39.43% and 63.53%.The Gini coefficient by population distribution was below 0.3.The Gini coefficient by geographic distribution was around 0.7.The results of Theil index showed a downward trend year by year,and the contribution rate of resource allocation difference within the region reached about 80%.Conclusions After the implementation of hierarchical[JP]diagnosis and treatment,the balance of the allocation of various types of health resources in China has improved overall,but the inverted triangle allocation pattern is still prominent.The imbalance of resource allocation in the eastern region is the most prominent,and the fairness of geographical distribution still needs attention.

关 键 词：分级诊疗 卫生资源配置 均衡性 泰尔指数 

分 类 号：R19[医药卫生—卫生事业管理]