江苏省某市卫生资源配置状况与公平性研究

发布时间：2018-06-13 04:19

本文选题：卫生资源 + 公平性　；参考：《南京医科大学》2017年硕士论文

【摘要】：目的:本研究的主要目标是了解江苏省某市近五年医疗卫生资源配置的基本情况,对2010-2015年江苏省某市医疗卫生资源的配置状况和卫生服务利用情况进行分析,评价医疗卫生资源配置的合理性和公平性,提出优化江苏省某市医疗卫生资源配置的政策建议,为卫生行政部门优化医疗卫生资源配置提供科学的参考依据,实现江苏省某市医疗卫生事业更好、更健康的发展。方法:通过文献研究了解国内外对医疗卫生资源配置现状及公平性研究进展,构建理论研究体系。通过描述性分析研究掌握江苏省某市社会经济和人口健康状况、医疗卫生资源配置和医疗卫生服务利用情况以及卫生资源发展情况,总结江苏省某市医疗卫生资源配置特点。在此基础上运用基尼系数和泰尔指数两种方法从常住人口分布和地理面积分布两个维度对江苏省某市的医疗卫生机构、床位、执业(助理)医师、注册护士资源进行公平性分析。结果:在资源配置方面,江苏省某市近年来医疗资源总量不断增加但资源分布不合理,大多数卫生资源集中在中心城区和三级医院,经济发展较为落后的周边地区卫生资源较少;基层医疗卫生资源不足;医护比例失衡。在公平性方面,按人口配置的基尼系数处于0～0.3之间,按地理配置的基尼系数处于0.3～0.6之间;按人口配置的泰尔指数处于0～0.3之间,按地理配置的泰尔指数处于0.1～0.5之间,江苏省某市的医疗卫生资源配置公平性逐年改善,按人口配置的公平性优于按地理配置。在人口配置上,医疗卫生机构基尼系数在0～0.2之间,达到高度公平,其他均为比较公平;在地理配置上,除医疗卫生机构资源,其他医疗卫生资源配置均不公平,不公平程度从大到小依次是床位资源、执业(助理)医师资源、注册护士资源。结论:需要通过加强区域卫生规划、优化卫生资源配置、改善医护比例、加大基层卫生资源投入等方式来促进江苏省某市的医疗卫生资源合理分布,提高居民对卫生服务利用的公平性和可及性,满足居民健康需求,促使江苏省某市卫生事业健康、可持续发展。
[Abstract]:Objective: the main objective of this study was to understand the basic situation of medical and health resources allocation in a certain city of Jiangsu Province in recent five years, and to analyze the allocation of medical and health resources and the utilization of health services in a certain city of Jiangsu Province from 2010 to 2015. To evaluate the rationality and fairness of the allocation of medical and health resources, and to put forward some policy suggestions for optimizing the allocation of medical and health resources in a certain city of Jiangsu Province, and to provide a scientific reference basis for the administrative departments of health to optimize the allocation of medical and health resources. To achieve a city in Jiangsu Province better health care, more healthy development. Methods: to study the status quo and equity of medical and health resources allocation at home and abroad through literature study, and to construct a theoretical research system. Through descriptive analysis, the author grasped the social economy and population health status, the allocation of medical and health resources, the utilization of medical and health services and the development of health resources in a certain city of Jiangsu Province, and summarized the characteristics of the allocation of medical and health resources in a certain city of Jiangsu Province. On this basis, Gini coefficient and Tyr index are used to analyze the medical and health institutions, beds and assistant doctors in a certain city of Jiangsu Province from the two dimensions of resident population distribution and geographical area distribution. The fairness of registered nurse resources was analyzed. Results: in terms of resource allocation, the total amount of medical resources in a certain city of Jiangsu Province has been increasing in recent years, but the distribution of resources is unreasonable. Most of the health resources are concentrated in the central urban area and tertiary hospitals. There are less health resources in peripheral areas with backward economic development, insufficient primary medical and health resources, and unbalanced health care ratio. In terms of equity, the Gini coefficient of population allocation is between 0 and 0.3, that of geographical allocation is between 0.3 and 0.3, and that of population allocation is between 0 and 0.3. The Taier index of geographical allocation is between 0.1 and 0.5, and the fairness of allocation of medical and health resources in a certain city of Jiangsu Province is improved year by year, and the fairness of allocation by population is better than that by geography. In terms of population allocation, the Gini coefficient of medical and health institutions was between 0 and 0.2, which reached a high degree of equity, while the rest were fairly equitable. In terms of geographical allocation, the allocation of other medical and health resources, except for medical and health institutions, was not fair. The unfair degree from big to small is bed resources, practicing (assistant) doctors resources, registered nurses resources. Conclusion: it is necessary to promote the rational distribution of medical and health resources in a certain city of Jiangsu Province by strengthening regional health planning, optimizing the allocation of health resources, improving the proportion of medical care and medical care, and increasing the input of primary health resources. To improve the fairness and accessibility of the utilization of health services, to meet the health needs of residents, and to promote the healthy and sustainable development of a city in Jiangsu Province.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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