中国西部地区全科医生资源配置公平性分析及需求预测研究  

Equity Analysis and Demand Prediction of General Practitioner Resource Allocation in Western China

作　　者：张兰 张瑞华 吴雪莲 杨燕 段桂敏 赵大仁 ZHANG Lan;ZHANG Ruihua;WU Xuelian;YANG Yan;DUAN Guimin;ZHAO Daren(School of Management,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;General Practitioners Training Center of Sichuan Province,Chengdu 610015,China;Reform,Innovation and Operations Expansion Department,the Third People's Hospital of Chengdu,Chengdu 610031,China;Department of Medical Administration,Sichuan Provincial Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]成都中医药大学管理学院,四川省成都市611137 [2]四川省全科医师培训中心,四川省成都市610015 [3]四川省成都市第三人民医院改革创新与运营拓展部,610031 [4]四川省骨科医院质控办,四川省成都市610041

出　　处：《中国全科医学》2024年第25期3171-3177,共7页Chinese General Practice

基　　金：教育部人文社会科学规划基金项目(21YJAZH016);四川省基层卫生事业发展研究中心(SWFZ22-Z-02);四川省基层卫生事业发展研究中心(SWFZ21-Q-59)。

摘　　要：背景全科医生是居民健康的守门人,其资源的合理配置是实现卫生服务公平性的基本保障。目前我国对全科医生配置方面的研究主要集中于全国和部分单体省份,缺乏针对以西部地区为研究对象的全科医生人力资源配置的研究。目的评价2015—2020年我国西部地区全科医生资源配置现状,为西部地区优化全科医生资源配置提供参考。方法本研究数据来源于2016—2017年《中国卫生和计划生育统计年鉴》、2018—2022年《中国卫生健康统计年鉴》、2016—2022年《中国统计年鉴》。运用阿特金森指数和区位熵对西部地区全科医生配置进行总体测算和具体分解;运用灰色预测模型对西部地区2022—2025年全科医生需求量进行预测。结果2015—2020年西部地区全科医生数从39290人增加至94652人,年均增长率为19.23%;2015年和2020年按人口、经济和地理面积分布的阿特金森指数分别是0.1265和0.0493、0.1244和0.0382、0.7865和0.6944;2020年西部各省份的人口、经济、地理指标的区位熵分别在0.7943~1.2190、0.6970~1.3373、0.0432~7.7270,西南地区地理配置区位熵>1,西北地区人口配置区位熵优于地理配置,甘肃省、青海省和广西壮族自治区经济指标的区位熵在研究年限内均>1;灰色模型预测2022—2025年西部地区全科医生数量呈增长趋势。结论西部地区全科医生资源配置水平逐渐提升,结构逐步优化,但仍存在总量不足、分布不均、注册率较低、公平性较差等问题。建议应以地理分级为标准,以“调增优存”为原则,以职业吸引力为目标,以资源整合和区域协同为导向,进一步优化西部地区全科医生资源配置。Background General practitioners(GPs)are gatekeepers of residents' health,the rational allocation of resources is the basic guarantee for achieving fairness in health services.At present,research on the allocation of GPs in China mainly focuses on the whole country and individual provinces,lack of research on the allocation of human resources for general practitioners in the western region as the research object.Objective To comprehensively evaluate the current situation of GPs resource allocation in western China from 2015 to 2020,provide a reference for optimizing the resources distribution of GPs in the western region of China.Methods The data for this study were derived from the China Health and Family Planning Statistical Yearbook(2016-2017),the China Health Statistics Yearbook(2018-2022),and the China Statistical Yearbook(2016-2022).Using Atkinson index and location entropy to calculate and decompose the overall allocation of GPs resources in the western region.Using grey prediction model to predict the demand for GPs in the western region from 2022 to 2025.Results From 2015 to 2020,the number of GPs in the western region increased from 39 290 to 94 652,with an average annual growth rate of 19.23%.The Atkinson Index by population,economy,and geography in 2015 and 2020 respectively were 0.1265 and 0.049 3,0.124 4 and 0.038 2,0.786 5 and 0.694 4.The location entropy of population,economy,and geographical indicators in the western provinces in 2020 respectively ranged from 0.794 3 to 1.219 0,0.697 0 to 1.337 3,and 0.043 2 to 7.7270.The location entropy of geographical allocation in the southwest region is greater than 1,while the location entropy of population allocation in the northwest region is better than geographical allocation.The location entropy of economic indicators in Gansu,Qinghai and Guangxi is greater than 1 during the research period.The grey model predicts that the resources of GPs in the western region will show an increasing trend from 2022 to 2025.Conciusion The allocation level of GPs in th

关 键 词：全科医生 资源配置 健康公平性 西部地区 阿特金森指数 区位熵 灰色预测 

分 类 号：R192[医药卫生—卫生事业管理]