重庆市基层医疗资源空间分布特征及影响因素研究

发布时间：2018-06-17 02:25

本文选题：基层医疗资源 + 空间分布　；参考：《第三军医大学》2016年硕士论文

【摘要】：基层医疗资源是指以社区卫生服务中心、乡镇卫生院和村卫生所(室)等为核心的医疗卫生机构所承载的人、财、物之和,也包括其运行体制与机制。基层医疗资源合理性的配置,对基本医疗卫生服务均等化的实现作用巨大,对医药卫生体制改革的进一步深化和中国特色基本医疗卫生制度的建立影响深远,对促进医疗卫生事业长远健康发展、提高人民健康水平、保障和改善民生具有重要意义。本文以重庆市基层医疗资源为研究的出发点和落脚点,借助卫生经济学、统计学与地理学等相关学科,选用空间统计、计量分析等方法手段,对重庆市基层医疗资源空间分布、变动特征以及影响因素进行分析研究。本文以重庆市基层医疗资源为对象,着手以下几点研究:(1)从基层医疗资源比重、密度等方面对重庆市基层医疗资源空间分布及其变动特征进行分析,同时采用Moran指数等空间统计方法研究重庆市基层医疗资源,探讨其空间自相关性和空间分布情况,总结出重庆市基层医疗资源在不同地域的空间分布与变化特性,揭示其分布规律;(2)在了解重庆市基层医疗资源空间分布及其变动特征的基础上,运用Pearson相关性分析方法,对影响重庆市基层医疗资源的自然因素和社会经济因素进行了分析;(3)针对重庆市基层医疗资源空间分布及其变动所呈现出的特征,结合其影响因素,对重庆市基层医疗资源空间配置存在的问题进行了分析,并进一步提出了合理布局的对策建议。研究结果发现:(1)无论是从基层医疗机构还是基层医疗人员的分布比重、分布密度来看,重庆市基层医疗资源在空间分布上都存在不均等的状况,存在明显的空间差异。重庆市基层医疗资源的分布具有明显的正向空间自相关性,即各区县基层医疗资源的空间分布没有随机性,而是在相似值之间具有空间集聚效应;(2)基层医疗资源的空间分布格局与自然因素和社会经济因素密切相关;(3)针对重庆市基层医疗资源空间配置存在的问题,从合理规划布局城乡医疗资源、拓宽基层医疗费用来源、建立城乡医护技术帮扶制度以及引导实现基层就医患者合理分流等方面,提出了实现重庆市基层医疗资源合理配置的对策建议。
[Abstract]:The primary medical resources refer to the sum of the people, wealth and things, including its operating system and mechanism, which are carried by the community health service center, the township health center and the village health center (room). The rational allocation of primary medical resources has a great effect on the realization of equalization of basic medical and health services, and has a profound impact on the further deepening of the reform of the medical and health system and the establishment of the basic medical and health system with Chinese characteristics. It is of great significance to promote the long-term development of medical and health care, to improve the health level of the people and to ensure and improve the people's livelihood. In this paper, the basic medical resources of Chongqing City as the starting point and foothold, with the help of health economics, statistics and geography and other related disciplines, the use of spatial statistics, metrological analysis and other methods, to Chongqing grass-roots medical resources spatial distribution. The change characteristics and influencing factors were analyzed and studied. This paper takes the primary medical resources of Chongqing as the object, and begins to study the following points: 1) analyzing the spatial distribution and variation characteristics of the primary medical resources in Chongqing from the aspects of the proportion and density of the primary medical resources, etc. At the same time, the spatial statistical method such as Moran index is used to study the spatial autocorrelation and spatial distribution of the primary medical resources in Chongqing, and the spatial distribution and variation characteristics of the primary medical resources in different regions of Chongqing are summarized. On the basis of understanding the spatial distribution and changing characteristics of primary medical resources in Chongqing, Pearson correlation analysis method was used. Based on the analysis of the natural and social economic factors affecting the primary medical resources in Chongqing, this paper analyzes the characteristics of the spatial distribution and changes of the primary medical resources in Chongqing, and combines the influencing factors. The problems existing in the spatial allocation of medical resources at the grass-roots level in Chongqing were analyzed, and the countermeasures and suggestions for the rational distribution of medical resources were put forward. The results show that the distribution proportion and density of primary medical personnel in Chongqing are not equal in spatial distribution, and there are obvious spatial differences in the distribution of primary medical resources in Chongqing. (1) in terms of distribution density and distribution density of primary medical personnel, there are obvious differences in spatial distribution of primary medical resources in Chongqing. The distribution of primary medical resources in Chongqing has obvious positive spatial autocorrelation, that is, the spatial distribution of primary medical resources in all districts and counties is not random. The spatial distribution pattern of primary medical resources is closely related to natural factors and social and economic factors. From the aspects of rational planning and distribution of urban and rural medical resources, broadening the sources of primary medical expenses, establishing the system of medical technical assistance in urban and rural areas, and guiding the realization of rational diversion of patients seeking medical treatment at the grass-roots level, etc. The countermeasures and suggestions to realize the rational allocation of medical resources at the grass-roots level in Chongqing were put forward.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R197.1

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