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健康中国战略下长江经济带医疗资源配置公平性研究。

Research on equity of medical resource allocation in Yangtze River Economic Belt under healthy China strategy.

机构信息

School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

China State Construction Northwestern Regional Headquarters, China State Construction Silkroad Construction Investment Group co., LTD, Xian, Shanxi, China.

出版信息

Front Public Health. 2023 Jun 26;11:1175276. doi: 10.3389/fpubh.2023.1175276. eCollection 2023.

Abstract

OBJECTIVE

This study aimed to assess the fairness of medical resource allocation in the Yangtze River Economic Belt, based on the Healthy China strategy. It aimed to identify the issues with resource allocation fairness and provide optimization suggestions.

METHODS

To assess the allocation fairness from a geographical population perspective, the study used the Health Resource Concentration and Entropy Weight TOPSIS methods. Additionally, the study analyzed the allocation fairness from an economic level angle, using the Concentration Curve and Concentration Index.

RESULTS

The study found that the downstream area had higher resource allocation fairness than the midstream and upstream areas. The middle reaches had more resources than the upper and lower reaches, based on population concentration. The Entropy Weight TOPSIS method found that Shanghai, Zhejiang, Chongqing, and Jiangsu had the highest comprehensive score index of agglomeration. Furthermore, from 2013 to 2019, the fairness of medical resource distribution gradually improved for different economic levels. Government health expenditure and medical beds were distributed more equitably, while general practitioners had the highest level of unfairness. However, except for medical and health institutions, traditional Chinese medicine institutions, and primary health institutions, other medical resources were mostly distributed to areas with better economic conditions.

CONCLUSION

The study found that the fairness of medical resource allocation in the Yangtze River Economic Belt varied greatly based on geographical population distribution, with inadequate spatial accessibility and service accessibility. Although the fairness of distribution based on economic levels improved over time, medical resources were still concentrated in better economic areas. The study recommends improving regional coordinated development to enhance the fairness of medical resource allocation in the Yangtze River Economic Belt.

摘要

目的

本研究旨在基于健康中国战略,评估长江经济带的医疗资源配置公平性,识别资源配置公平性存在的问题,并提出优化建议。

方法

从地理人口角度评估配置公平性,采用卫生资源集聚度和熵权 TOPSIS 方法;从经济水平角度分析配置公平性,采用集中曲线和集中指数。

结果

研究发现,下游地区的资源配置公平性高于中上游地区;基于人口集聚度,中游地区的资源多于上、下游地区。熵权 TOPSIS 方法表明,上海、浙江、重庆和江苏的集聚综合评分指数最高。此外,2013-2019 年,不同经济水平的医疗资源分布公平性逐渐提高。政府卫生支出和医疗床位分配更为公平,而全科医生的不公平程度最高。但除了医疗和卫生机构、中医机构和基层卫生机构外,其他医疗资源主要分布在经济条件较好的地区。

结论

研究发现,长江经济带医疗资源配置公平性在地理人口分布上存在较大差异,空间可达性和服务可达性不足。虽然基于经济水平的分配公平性随时间推移有所改善,但医疗资源仍集中在经济条件较好的地区。研究建议通过改善区域协调发展,提高长江经济带医疗资源配置的公平性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/611f/10332165/3b4a859de731/fpubh-11-1175276-g001.jpg

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