基于复合系统协同度模型的我国医疗服务体系与公共卫生体系协同发展分析  

Analysis of the collaborative development of medical service system and public health system based on composite system synergy model

作　　者：祝翠悦 唐尚锋 付航 袁素维 ZHU Cuiyue;TANG Shangfeng;FU Hang;YUAN Suwei(Children's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200062,PRC;不详)

机构地区：[1]上海市儿童医院/上海交通大学医学院附属儿童医院,上海市200062 [2]华中科技大学同济医学院医药卫生管理学院,湖北省武汉市430030 [3]郑州大学附属第一医院,河南省郑州市450000 [4]上海交通大学医学院附属仁济医院,上海市200127

出　　处：《中国医院》2023年第10期31-34,共4页Chinese Hospitals

基　　金：国家自然科学基金青年项目(72004136);上海市公共卫生体系建设三年行动计划(2020-2022年)优秀人才项目(GWV-10.2-YQ51);教育部人文社会科学基金项目(20YJC630134)。

摘　　要：目的:基于复合系统协同度模型,测量医疗服务系统和公共卫生系统协同发展程度。方法:根据卫生资源配置评价相关指标,分别构建医疗服务系统(S_(1))和公共卫生系统(S_(2))的协同度评价框架;采集相关年鉴数据,测量2010-2020年S_(1)和S_(2)的有序度以及复合系统间的协同度。结果:2010-2020年,S_(1)和S_(2)内部的有序度和系统间的协同度均呈现快速上升态势;医疗-公卫复合系统的协同度先下降后快速上升,2020年达到一般协同状态(0.63)。从不同序参量的结果看,每千人口床位数、万元以上设备数、房屋建筑面积在不同系统间稳步正向协同发展;每千人口卫技人员的协同水平较弱且波动较大;每千人口机构数则始终处于不协同状态。结论:2010年以来,S_(1)和S_(2)的有序度不断提升,复合系统的协同度不断增强;后续卫生资源配置规划中,需着重加强基层医疗机构的应急能力建设及系统间人力资源配置的协同,逐步探索将协同度分析引入卫生资源规划配置的新思路。Objective:To measure the degree of synergistic development of the health care delivery system and the public health system based on the composite system synergy model.Methods:Based on the relevant indicators of health resource allocation evaluation,the synergy evaluation frameworks of the medical service system(S_(1))and public health system(S_(2))were constructed separately;the relevant yearbook data were collected to measure the degree of orderliness of S_(1)and S_(2)as well as the degree of synergy between the composite systems from 2010 to 2020.Results:Rapid upward trends were seen within the two systems and between their collaborations from 2010 to 2020.The coordination degree of the medical-public health composite system showed a first down then up trend and reached a general coordination state in 2020(0.63).During the coordinated development of various elements,the number of beds per 1,000 population,the number of equipment above 10,000 yuan,and the degree of the synergy of the housing construction area were in a state of continuous coordinated development.The level of coordination of health technicians per 1,000 population was weak and fluctuated greatly.The number of institutions per 1,000 population in each system had been in a state of uncoordinated development.Conclusion:Since 2010,the orderliness of S_(1)and S_(2)has been improving,and the synergy of the composite system has been increasing;in the subsequent planning of health resource allocation,it is necessary to focus on strengthening the construction of emergency response capacity of grassroots medical institutions and the synergy of human resource allocation between systems,and gradually explore the new idea of introducing synergy analysis into the planning and allocation of health resources.

关 键 词：医疗服务系统 公共卫生系统 复合系统 有序度 协同度 

分 类 号：R197.1[医药卫生—卫生事业管理]