School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
School of Medical Humanities, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
BMC Prim Care. 2024 Feb 21;25(1):62. doi: 10.1186/s12875-024-02290-y.
The primary health care (PHC) system plays an important role in China's health care system, but there are challenges such as irrational allocation of health resources and inefficient operation, which need to be improved. The purpose of this study was to explore the impact of resource allocation on the efficiency of the PHC system in China.
The data in 31 provinces were collected from the China Statistical Yearbook 2017-2021 and the China Health Statistical Yearbook 2017-2021. The comprehensive health resource density index (CHRDI) was constructed based on the entropy method and the health resource density index (HRDI), which was used to analyze the allocation of primary health resources in each province. The adjusted efficiency of the PHC system in each province was calculated by the bootstrap data envelopment analysis (DEA). Finally, the spatial Dubin model was used to explore the effect of the CHRDI on efficiency.
From 2016 to 2020, the allocation of primary health resources in 31 provinces showed an increasing trend, and the average efficiency after correction showed a decreasing state year by year. The spatial direct effect and spatial spillover effect coefficients of CHRDI were 0.820 and 1.471, which positively affect the efficiency. Per capita Gross Domestic Product (GDP), urbanization rate, and the proportion of the elderly were the factors affecting the efficiency of the PHC system.
The allocation of primary health resources in all provinces in China has improved each year, but there are still great differences, and efficiency must be further improved. Pay attention to the spatial spillover effect of the level of resource allocation and formulate differentiated measures for different regions. Attention should also be paid to the impact of population aging and economic development on the utilization of primary health resources by increasing health needs and choices.
基层医疗保健（PHC）系统在中国的医疗保健系统中发挥着重要作用，但存在卫生资源配置不合理和运行效率低下等挑战，需要加以改进。本研究旨在探讨资源配置对中国基层医疗保健系统效率的影响。
从《中国统计年鉴 2017-2021》和《中国卫生统计年鉴 2017-2021》中收集了 31 个省的数据。基于熵值法构建了综合卫生资源密度指数（CHRDI），并用卫生资源密度指数（HRDI）来分析各省的基层卫生资源配置情况。利用 bootstrap 数据包络分析（DEA）计算各省基层医疗保健系统的调整效率。最后，采用空间杜宾模型探讨 CHRDI 对效率的影响。
2016 年至 2020 年，31 个省的基层卫生资源配置呈上升趋势，经修正后的平均效率呈逐年下降趋势。CHRDI 的空间直接效应和空间溢出效应系数分别为 0.820 和 1.471，均对效率产生正向影响。人均国内生产总值（GDP）、城市化率和老年人口比例是影响基层医疗保健系统效率的因素。
中国各省份基层卫生资源的配置水平逐年提高，但仍存在较大差异，需要进一步提高效率。要重视资源配置水平的空间溢出效应，为不同地区制定差异化措施。同时，要关注人口老龄化和经济发展对基层卫生资源利用的影响，增加健康需求和选择。
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