北京市医疗卫生区域划分:以恶性肿瘤为例  

Health region division in Beijing:A case study of cancer

作　　者：高路 周文卓 杨帆 李逸章 谢小磊 GAO Lu;ZHOU Wen-zhuo;YANG Fan;LI Yi-zhang;XIE Xiao-lei(Beijing Municipal Health Commission,Beijing 101160,China;Institute for Hospital Management,Tsinghua University,Shenzhen Guangdong 518055,China;The Research Center for Healthcare Data Standard,Institute for Hospital Management,Tsinghua University,Beijing 100083,China;Department of Industrial Engineering,Tsinghua University,Beijing 100084,China)

机构地区：[1]北京市卫生健康委员会,北京101160 [2]清华大学医院管理研究院,广东深圳518055 [3]清华大学医院管理研究院医疗数据标准化研究中心,北京100083 [4]清华大学工业工程系,北京100084

出　　处：《中国卫生政策研究》2024年第10期39-45,共7页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(72271137)。

摘　　要：目的:以恶性肿瘤为例,应用多维数据进行北京市医疗卫生区域划分,并应用指标比较区域划分结果。方法:应用基于医院服务范围进行区域划分的集水区方法,以及基于人口地理分布进行聚类的K-Means算法,并建立评价指标。结果:按医院服务范围划分出3个区域,按人口地理分布划分出8个区域,与按行政区划分相比,不同区域的每十万人口床位数与门诊需要满足率指标更加均衡。结论:北京市医疗资源配置不平衡问题显著,按医院服务范围分区增强了高质量医疗机构覆盖范围,按人口地理分布分区有利于反映各区域真实的医疗资源供需情况。建议:基于分区结果扩大高质量医院服务范围,平衡中心城区与郊区资源差异;并采用按人口地理分布的分区结果为卫生资源配置提供支撑。Objective:Using cancer care as an example,we apply multi-dimensional data for healthcare region division in Beijing,and apply indicators to compare the results of the divisions.Methods:We use two approaches:the hospital catchments division method based on the hospital service range,and the K-Means clustering algorithm based on the population geographic distribution from the residents'healthcare needs,and established two indicators for comparison.Results:Three regions are divided by hospital service range method and eight regions by population geographic distribution method.The indicators of the number of beds per 100000 population and the need satisfaction rate are more balanced among the different regions than when divided by administrative district.Conclusions:The distribution of healthcare resource in Beijing is significantly imbalanced.The region division based on hospital service range has extended the range of high-quality medical institutions.The division based on population geographical distribution reflects the actual supply and need of healthcare resources in different regions.Beijing can adopt the regional division method based on hospital service range to expand the service coverage of high-quality hospitals and reduce the imbalance in medical resources between central urban areas and suburban areas.The regional division based on population geographical distribution can provide decision support to achieve balanced allocation of healthcare resources.

关 键 词：恶性肿瘤 卫生服务需要 聚类分析 医疗差距 

分 类 号：R197[医药卫生—卫生事业管理]