分级诊疗背景下我国社区卫生资源配置评价研究

发布时间：2018-05-02 20:33

本文选题：社区卫生资源配置 + 公平　；参考：《南京中医药大学》2017年硕士论文

【摘要】：研究背景:分级诊疗被认为是解决我国长久以来"看病难、看病贵"等问题的关键步骤,也是全面深化医改的关键举措。社区卫生服务在提供基本医疗服务和基本公共卫生服务中起着重要作用,是我国基层医改中的重要组成部分,也是分级诊疗环节中基层首诊的实现者。但随着社区卫生服务的开展,社区卫生资源配置矛盾也日益凸显,存在着分配不均与资源浪费现象,导致社区居民医疗需求得不到满足。因此,对社区卫生资源配置的公平性及效率进行分析,能有效反映我国社区卫生资源配置与利用现状,发现资源配置中存在的问题,从而为推进分级诊疗顺利进行以及社区卫生资源配置提供建议。研究目的:为应对新的发展趋势,本文从资源配置的公平和效率两个角度,评价我国30个省市以及东中西部三大地区的社区卫生资源利用及配置情况,发现社区卫生资源配置中存在的问题,期望为社区卫生资源配置提供建议。研究方法:先描述性分析2011-2015我国年社区卫生资源配置与利用总体情况;然后运用洛伦茨曲线、基尼系数以及泰尔指数对我国社区卫生资源配置的公平性作出全面的分析;再从资源配置效率角度,运用数据包络分析模型,从横向和纵向两个时间维度对我国社区卫生资源配置进行分析,并将社区卫生资源配置的全要素生产率进行分解,进一步分析影响效率的主要原因。研究结果:我国社区卫生资源总体发展稳定,但东中西部资源配置上存在一定差异;医护比较低,社区卫生人力资源的结构还有待改善;社区卫生资源配置按地理分布的公平性还需进一步改善,地区内差异是影响总差异主要原因;社区卫生资源配置效率低,技术进步有影响全要素生产率趋势。研究结论:坚持公平与效率的统一,统筹区域社区卫生资源配置;大力推行分级诊疗,加强社区"基层首诊";加强社区卫生人才队伍建设;持续缩小社区卫生资源配置地区内部差异水平。
[Abstract]:Background: hierarchical diagnosis and treatment is regarded as a key step to solve the problem of "difficult and expensive to see a doctor" for a long time in China, and also a key measure to deepen medical reform in an all-round way. Community health service plays an important role in the provision of basic medical services and basic public health services. It is an important part of the basic medical reform in China, and it is also the implementer of the first diagnosis at the grass-roots level in the process of graded diagnosis and treatment. However, with the development of community health services, the contradiction of community health resources allocation has become increasingly prominent, there are uneven distribution and waste of resources, resulting in community residents' medical needs can not be met. Therefore, the analysis of the fairness and efficiency of the allocation of community health resources can effectively reflect the present situation of the allocation and utilization of community health resources in China, and find out the problems existing in the allocation of community health resources. So as to promote the classification of diagnosis and treatment smoothly and the allocation of community health resources to provide advice. Objective: in order to cope with the new development trend, this paper evaluates the utilization and allocation of community health resources in 30 provinces and cities of China and three regions in the east, west and west of China from the perspective of resource allocation fairness and efficiency. To find out the problems in the allocation of community health resources and to provide suggestions for the allocation of community health resources. Methods: firstly, the general situation of the allocation and utilization of community health resources in China from 2011 to 2015 was analyzed, and then the equity of the allocation of community health resources in China was analyzed by using Lorenz curve, Gini coefficient and Thiel index. Then from the perspective of resource allocation efficiency, using the data envelopment analysis model, this paper analyzes the allocation of community health resources in China from the horizontal and vertical time dimensions, and decomposes the total factor productivity of the allocation of community health resources. Further analysis of the main factors affecting efficiency. The results showed that the development of community health resources in China was stable, but there were some differences in the allocation of resources between east, west and west, and the structure of community health human resources needed to be improved. The fairness of the distribution of community health resources according to geographical distribution needs to be further improved, the regional differences are the main factors affecting the total differences, the efficiency of community health resources allocation is low, and the trend of total factor productivity is affected by technological progress. The conclusion of the study is: to insist on the unity of fairness and efficiency, to coordinate the allocation of regional community health resources, to vigorously carry out hierarchical diagnosis and treatment, to strengthen the "first diagnosis at the grass-roots level" in the community, to strengthen the construction of community health personnel; To reduce the level of community health resources allocation within the region.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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