CAJ | 학술논문

目的通过对我国医药卫生资源区域空间分布的研究,以期为政府优化配置卫生资源提供政策依据.方法将我国划分为3大经济和地理区域,选取6类医药卫生资源指标,依据2009年国家公布的31个省区的相关统计数据,应用变异系数、基尼系数、泰尔指数评价我国医药卫生资源区域空间分布的差异性.结果每万人口生物制药企业拥有量区域间的分布差异最大,而医疗机构床位数的配置分布差异相对最小.生物制药企业和三级医院万人口拥有量的区域间极差排在前2位.东部地区是6项资源在3大地理区域间或区域内的差异贡献的最大者,经济相对落后地区是形成执业(助理)医师、床位、三级医院和药品生产企业分布区域内差异的主要贡献者,而经济发达地区对地区政府人均医疗卫生支出和生物制药企业区域间分布差异的贡献最大.总体上,经济发展水平高的地区,其人口资源拥有率也相对更高.但是,两者之间并不完全呈正比关系.结论 6类资源在我国区域间的分布均未表现出"相对合理"的状态.为更好地满足地区人群的卫生需求,政府应加大对经济不发达的西部地区生物制药产业和三级医院建设的投入,提高经济发达地区资源的有效利用和防止低水平重复建设,持续关注人均医药卫生的支出比例和执业医师的数量与质量.
목적 통과대아국의약위생자원구역공간분포적연구,이기위정부우화배치위생자원제공정책의거.방법 장아국화분위3대경제화지리구역,선취6류의약위생자원지표,의거2009년국가공포적31개성구적상관통계수거,응용변이계수、기니계수、태이지수평개아국의약위생자원구역공간분포적차이성.결과 매만인구생물제약기업옹유량구역간적분포차이최대,이의료궤구상위수적배치분포차이상대최소.생물제약기업화삼급의원만인구옹유량적구역간겁차배재전2위.동부지구시6항자원재3대지리구역간혹구역내적차이공헌적최대자,경제상대락후지구시형성집업(조리)의사、상위、삼급의원화약품생산기업분포구역내차이적주요공헌자,이경제발체지구대지구정부인균의료위생지출화생물제약기업구역간분포차이적공헌최대.총체상,경제발전수평고적지구,기인구자원옹유솔야상대경고.단시,량자지간병불완전정정비관계.결론 6류자원재아국구역간적분포균미표현출"상대합리"적상태.위경호지만족지구인군적위생수구,정부응가대대경제불발체적서부지구생물제약산업화삼급의원건설적투입,제고경제발체지구자원적유효이용화방지저수평중복건설,지속관주인균의약위생적지출비례화집업의사적수량여질량.
Objective Analyzing the regional distribution discrepancy of medical and health resources in China,with the purpose of providing the government with policy making evidences for optimizing medical and health resource allocation.Results Dividing China into three regions based on regional economic development and geographic setting,and selecting 6 indicators for medical and health resources.On the basis of the statistics of 31 provinces released by the state in 2009,analyzing the interprovincial disparities of the distribution of these six resources,by means of the coefficient of variation,Gini coefficient and Theil index.Methods The largest inter-regional allocation disparity is found in the number of biopharmaceutical manufacturing companies per ten thousand population.And the smallest discrepancy is found in the number of hospital beds among these regions.The top two extreme differences of resource possession per ten thousand population between the maximum and the minmum region are the number of biopharmaceutical manufacturing companies and tertiary hospitals.The eastern region is the largest contributor to the discrepancy of allocation for the six resources within and between regions.The less developed regions contribute the most inter-regional discrepancy for the allocation of medical practitioners(their assistants included),hospital beds,tertiary hospitals and pharmaceutical companies.And the developed regions contribute the most inter-regional discrepancy of medical finance support from local governments and the most of the allocation of biopharmaceutical manufacturing companies.In general,regions of higher development enjoy greater possession of the SIX resources per population in such regions. But these two are not always in direct proportion. Condnsion Regional distribution disparity of the six resources is not yet"reasonable" in China.To better meet the health needs of the population in various regions,the government is expected to increase its financial support for building biopharmaceutical manufacturing companies and tertiary hospitals in the less developed western regions,to better use resources of developed regions,and to keep off investments at low level and repetition.The government is also recommended to pay attention to the proportion of government health finance output and the quality and quantity of medical practitioners.