摘要
目的分析我国县级医院卫生资源配置效率的时空特征及影响因素,为优化县级医院卫生资源配置提供参考。方法基于2012年-2022年我国28个省(自治区、直辖市)面板数据,借助超效率SBM模型测算县级医院卫生资源配置效率,运用核密度估计、Dagum基尼系数揭示其时间演化趋势与空间分布特征,并通过Tobit模型检验配置效率外部影响因素。结果2012年-2022年,我国县级医院卫生资源配置效率均值为0.708,整体效率偏低,医院数量存在较大冗余且门诊诊疗人次不足。时间演化上呈现波动下降趋势,空间分布上存在明显区域差异(东部>西部>中部),主要来源于超变密度差异。人均可支配收入、城镇化水平、财政卫生健康支出是影响卫生资源配置效率的外部因素(P<0.05)。结论调整县级医院数量,增强患者本地就诊意愿,推动区域内均衡发展同时防止区域间差异进一步扩大,优化卫生资源配置外部环境。
Objective To analyze the spatiotemporal characteristics and influencing factors of health resource allocation efficiency in county-level hospitals in China,and to provide references for optimizing health resource allocation in these hospitals.Methods Based on panel data from 28 provinces(autonomous regions,municipalities directly under the central government)in China from 2012 to 2022,the super-efficiency SBM model was employed to measure the health resource allocation efficiency in county-level hospitals.Kernel density estimation and the Dagum Gini coefficient were utilized to reveal the temporal evolution trend and spatial distribution characteristics.Additionally,the Tobit model was applied to examine the external influencing factors of allocation efficiency.Results From 2012 to 2022,the mean health resource allocation efficiency in county-level hospitals in China was 0.708,indicating an overall low efficiency.There was a significant redundancy in the number of hospitals and an insufficient number of outpatient visits.A fluctuating downward trend was observed over time,with notable regional disparities in spatial distribution(eastern>western>central regions),primarily stemming from differences in hypervariable density.Per capita disposable income,urbanization level,and fiscal health expenditure were identified as external factors influencing health resource allocation efficiency(P<0.05).Conclusion It is recommended to adjust the number of county-level hospitals,enhance patients'willingness to seek local medical treatment,promote balanced development within regions while preventing further widening of inter-regional disparities,and optimize the external environment for health resource allocation.
作者
王弦弦
杨璐
邓燕
罗红芳
庄毓
徐颖
蔡郑东
WANG Xianxian;YANG Lu;DENG Yan(Shanghai First People's Hospital Jintan Branch/The First People's Hospital of Jintan,Changzhou,Jiangsu,213200,China;不详)
出处
《中国卫生质量管理》
2025年第8期114-119,共6页
Chinese Health Quality Management
基金
江苏省医院协会医院管理创新研究课题(编号:JSYGY-3-2023-269,JSYGY-3-2024-145)。
关键词
县级医院
卫生资源
配置效率
分级诊疗
County-Level Hospitals
Health Resources
Allocation Efficiency
Hierarchical Diagnosis and Teatment
