我国基层卫生人力资源配置的区域差异、动态演进及优化策略研究  

Regional differences,dynamic evolution and optimization strategies of human resource allocation of primary health care in China

作　　者：陆苗 方金勇 刘海荣 张明敏 王国平 LU Miao;FANG Jinyong;LIU Hairong;ZHANG Mingmin;WANG Guoping(School of Humanities and Management,Wannan Medical College,Wuhu 241002;Office,Ma’anshan Fourth People’s Hospital,Ma’anshan 243000,China)

机构地区：[1]皖南医学院人文与管理学院,安徽芜湖241002 [2]马鞍山市第四人民医院办公室,安徽马鞍山243000

出　　处：《南京医科大学学报(社会科学版)》2025年第2期203-208,共6页Journal of Nanjing Medical University(Social Sciences)

基　　金：安徽省教育厅人文社会科学研究项目“基于社会期望的公立医院人文关怀制度建设研究”(SK2019ZD19);安徽省高校哲学社会科学研究项目“人才引进政策评价与仿真研究——以‘紫云英人才计划’为例”(2023AH040236)。

摘　　要：基于2012—2022年省级面板数据,综合运用Dagum基尼系数分解、核密度非参数估计及马尔可夫链分析方法,系统探究我国基层卫生人力资源配置的空间差异特征与动态演进规律。结果显示,①核密度曲线在观测期内呈现右移态势,年均增长率西部最高(2.65%)、中部最低(1.86%)。②Dagum基尼系数整体呈现平稳下降趋势;中部地区的基尼系数低于东部和西部。③马尔可夫链转移概率矩阵显示各层级间存在较强的状态稳定性。结果表明,我国基层卫生人力资源配置水平总体呈上升趋势但区域差异明显,公平性持续优化过程中形成中部均衡引领特征,而配置状态的高稳定性需要通过制度创新实现动态突破。应增强区域内和区域间各省份之间的空间联动,缩小区域差异;发挥政府的宏观干预作用,持续促进基层卫生人力资源配置公平性;完善基层医疗卫生服务体系,不断推动制度创新。Based on provincial panel data from 2012 to 2022,this study employs an integrated analytical framework combining Dagum Gini coefficient decomposition,kernel density non-parametric estimation,and Markov chain analysis to systematically investigate the spatial disparities and dynamic evolution of primary healthcare human resource allocation in China.Key findings reveal three principal outcomes.First,the kernel density curve shows a rightward shift over the observation period,with the highest average annual growth rate in the western region(2.65%)and the lowest in the central region(1.86%).Second,the Dagum Gini coefficient shows a steady declining trend overall.The central region has the lowest Gini coefficient compared to the eastern and western regions.Third,the Markov chain transition probability matrix reveals strong state stability across allocation tiers,indicating high structural stability.The overall level of primary healthcare human resource allocation in China is generally on the rise,but regional differences are still evident.During the continuous optimization of equity,a balanced development pattern in the central region shows a leading role in achieving equilibrium.However,the high stability of the current allocation status requires dynamic breakthroughs through institutional innovation.To address these challenges,we propose three policy recommendations,including strengthening spatial linkages both within and across provinces to reduce geographical disparities,utilizing government-led macro-interventions to optimize equity in resource distribution,improving the primary healthcare service system,and continuously promoting institutional innovation.

关 键 词：基层卫生人力资源 区域差异 动态演进 

分 类 号：R197.1[医药卫生—卫生事业管理]