医疗资源配置效率的小区域时空评价:基于四川省县域面板数据的实证研究  

Empirical Study on the Small-Area Spatiotemporal Evaluation of Healthcare Resource Allocation Efficiency Based on County-Level Panel Data in Sichuan Province

作　　者：罗雅玲 唐欣怡 解铭宇 严国强 唐先腾 唐章英[4] 王秀丽 潘杰 宋超[1,2] Luo Yaling(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,P.R.China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,四川成都610041 [2]四川大学健康城市发展研究中心.西部农村卫生发展研究中心 [3]西安交通大学公共卫生学院 [4]西南石油大学地球科学与技术学院.油气藏地质国家重点实验室

出　　处：《中国卫生事业管理》2025年第3期292-299,共8页Chinese Health Service Management

基　　金：国家自然科学基金委员会项目“基于贝叶斯时空变系数模型的中国孕产妇死亡局域环境影响机制及精细制图”、“健康公平视角下的医疗质量与医疗卫生资源空间可及性评估:现状、影响及优化研究”(42071379;72204175);四川大学华西公共卫生学院/华西第四医院健康新质生产力研究所课题“中国城市医疗卫生资源的多指标时空联合评价”、“数智驱动的残疾儿童康复服务体系研究”(HN240301A;HN240308A)。

摘　　要：中国于2024年进入县域医共体全面建设阶段,亟需评价小区域医疗资源配置效率的时空不公平差异。本文选取2009~2016年四川省县域医疗资源投入和产出指标测算效率并探测其时空不均衡与地理集聚区,利用贝叶斯时空变系数模型与时空方差分割指标拟合社会经济与自然环境的时空异质影响机制进而识别关键驱动因素。三类医疗资源配置效率(综合效率、纯技术效率、规模效率)整体均较低,且呈现出显著的时空不均衡与地理集聚特征。三种效率的共同时空驱动因素包括地方财政支出、地区生产总值等社会经济因素以及海拔、夜间灯光等环境因素。四川省应结合地区经济水平与特殊地理环境,制定动态调整、适应本地需求的医疗资源配置优化政策,以支持县域医共体的建设与发展。China has entered the comprehensive construction phase of"county medical service community"in 2024,which needs an evaluation of the spatiotemporal inequities in healthcare resource allocation efficiency at a small area scale.The healthcare input-output indicators from 2009 to 2016 in Sichuan Province were used to evaluate the allocation efficiency,identify spatiotemporal balance,and detect spatiotemporal geographic clustering patterns.Bayesian Spatiotemporal Varying Coefficients(STVC)model and Spatiotemporal Variance Partitioning Index(STVPI)were applied to explore the heterogeneous spatiotemporal impact mechanisms of socioeconomic and environmental factors and identify key driving factors.Three types of healthcare resource allocation efficiency(overall efficiency,pure technical efficiency,and scale efficiency)were generally low,showing marked spatiotemporal inequities and geographic clustering patterns.The common spatiotemporal drivers for three efficiencies include socioeconomic factors like local fiscal expenditure and gross regional product,as well as environmental factors such as altitude,nighttime lighting.It is suggested to formulate dynamically regulated policies of healthcare resource allocation to support the construction and development of county-level medical communities,combining with local conditions,regional economic levels and specific geographical conditions.

关 键 词：医疗资源配置效率 小区域时空差异 时空异质驱动因素 贝叶斯时空变系数模型 时空方差分割指标 

分 类 号：R19[医药卫生—卫生事业管理]