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中国卫生资源生产效率的时空格局及其影响因素。

The spatio-temporal pattern and its influencing factors of production efficiency of health resources in China.

机构信息

College of Architecture and Urban Planning, Hunan City University, Yiyang, Hunan, China.

College of Urban and Environmental Sciences, Central China Normal University, Wuhan, Hubei, China.

出版信息

Front Public Health. 2024 Apr 16;12:1376518. doi: 10.3389/fpubh.2024.1376518. eCollection 2024.

Abstract

There is always a contradiction between the limited health resources and the unlimited demand of the population for health services, and only by improving the productivity of health resources can the health level of the population be improved as much as possible. Using prefecture-level administrative regions as spatial units, the paper analyzes the spatial pattern and changes of health productivity of health resources in China from 2000 to 2010, and uses a spatial panel Tobit model to examine the effects of factors such as technical level of health institutions, health service accessibility, public health policies and ecological environment quality on health productivity of health resources. The results show that with the Hu Huanyong line as the dividing line, the spatial heterogeneity of "high in the southeast and low in the northwest" in the health productivity of China's health resources is clear; as the regional differences narrow, the spatial correlation increases, and the spatial pattern of "overall dispersion and partial agglomeration" becomes more obvious. The fitting results of the spatial Durbin model reveal the direction and degree of influence of local and adjacent factors on the production efficiency of health resources. The positive influence of technical level of local health institutions and the accessibility of health services, the literacy level and the ability to pay for health services of residents in adjacent areas, the degree of urbanization of regional health resource allocation, climate suitability and the quality of the atmospheric environment are significant. And the negative influence of local residents' literacy and ability to pay for health services, the technical level of health institutions in adjacent areas and the degree of medicalization of health resource allocation are also significant. The influence of the degree of medicalization of local health resource allocation and the accessibility of health services in adjacent areas are significantly spatial-heterogeneous.

摘要

卫生资源的有限性与人口对卫生服务的无限需求之间始终存在矛盾,只有提高卫生资源的生产力,才能最大限度地提高人口的健康水平。本文以地级市为空间单元,分析了 2000-2010 年中国卫生资源健康生产力的空间格局及其变化,并利用空间面板 Tobit 模型考察了医疗机构技术水平、卫生服务可及性、公共卫生政策和生态环境质量等因素对卫生资源健康生产力的影响。结果表明,以胡焕庸线为分界线,中国卫生资源健康生产力呈现“东南高、西北低”的空间异质性;随着区域差异的缩小,空间相关性增加,“整体分散、局部集聚”的空间格局更加明显。空间杜宾模型的拟合结果揭示了局部和邻近因素对卫生资源生产效率的方向和程度的影响。本地医疗机构的技术水平和卫生服务的可及性、居民的文化水平和卫生服务支付能力、区域卫生资源配置的城市化程度、气候适宜性和大气环境质量对生产效率有正向显著影响。本地居民的文化水平和卫生服务支付能力、邻近地区医疗机构的技术水平以及卫生资源配置的医疗化程度对生产效率有负向显著影响。本地卫生资源配置的医疗化程度和邻近地区卫生服务可及性的影响具有显著的空间异质性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee7f/11058211/bbf25c8e86af/fpubh-12-1376518-g0001.jpg

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