中国卫生政策研究
中國衛生政策研究
중국위생정책연구
CHINESE JOURNAL OF HEALTH POLICY
2014年
4期
67-72
,共6页
基本医疗卫生服务%均等化%基尼系数%卫生筹资
基本醫療衛生服務%均等化%基尼繫數%衛生籌資
기본의료위생복무%균등화%기니계수%위생주자
Essential health care%Equity%Gini coefficient%Health financing
目的：了解海南省市县际间基本医疗卫生服务均等化现状,为促进全省基本医疗卫生服务均等化建设提供参考。方法：利用海南省、我国及经合组织国家等卫生统计数据,对海南省市县际间基本医疗卫生服务均等化指标进行分析。结果：资源分布均等化方面,机构地理可及性相差较大,医护比为1∶1．2,资源分布的基尼系数大于0．3；筹资均等化方面,人均医疗保健支出低于全国,人均政府卫生支出额高的市县主要集中在各区域的中心,多数市县新农合住院实际补偿比在50%左右；服务提供均等化方面,多数市县床位使用率低于90%,药费占比在30%~40%,地区之间孕产妇及儿童健康管理差距较小,但管理率普遍低于全国。结论：基本医疗卫生服务资源分布与政治、经济等条件有关,筹资机制不健全、基本医疗和公共卫生服务提供能力低影响了基本医疗卫生服务的质量。建议合理布局基本医疗卫生服务资源,加大卫生筹资力度,提高基本医疗卫生服务提供能力。
目的：瞭解海南省市縣際間基本醫療衛生服務均等化現狀,為促進全省基本醫療衛生服務均等化建設提供參攷。方法：利用海南省、我國及經閤組織國傢等衛生統計數據,對海南省市縣際間基本醫療衛生服務均等化指標進行分析。結果：資源分佈均等化方麵,機構地理可及性相差較大,醫護比為1∶1．2,資源分佈的基尼繫數大于0．3；籌資均等化方麵,人均醫療保健支齣低于全國,人均政府衛生支齣額高的市縣主要集中在各區域的中心,多數市縣新農閤住院實際補償比在50%左右；服務提供均等化方麵,多數市縣床位使用率低于90%,藥費佔比在30%~40%,地區之間孕產婦及兒童健康管理差距較小,但管理率普遍低于全國。結論：基本醫療衛生服務資源分佈與政治、經濟等條件有關,籌資機製不健全、基本醫療和公共衛生服務提供能力低影響瞭基本醫療衛生服務的質量。建議閤理佈跼基本醫療衛生服務資源,加大衛生籌資力度,提高基本醫療衛生服務提供能力。
목적：료해해남성시현제간기본의료위생복무균등화현상,위촉진전성기본의료위생복무균등화건설제공삼고。방법：이용해남성、아국급경합조직국가등위생통계수거,대해남성시현제간기본의료위생복무균등화지표진행분석。결과：자원분포균등화방면,궤구지리가급성상차교대,의호비위1∶1．2,자원분포적기니계수대우0．3；주자균등화방면,인균의료보건지출저우전국,인균정부위생지출액고적시현주요집중재각구역적중심,다수시현신농합주원실제보상비재50%좌우；복무제공균등화방면,다수시현상위사용솔저우90%,약비점비재30%~40%,지구지간잉산부급인동건강관리차거교소,단관리솔보편저우전국。결론：기본의료위생복무자원분포여정치、경제등조건유관,주자궤제불건전、기본의료화공공위생복무제공능력저영향료기본의료위생복무적질량。건의합리포국기본의료위생복무자원,가대위생주자력도,제고기본의료위생복무제공능력。
Objective:To analyze essential health care equity in cities and counties of Hainan in order to provide the basis for its development. Methods:Based on health statistics of Hainan, China and OECD countries, indicators of essential health care equity in cities and counties were analyzed. Results:Equity in distribution of resources, the hospi-tal geographical distance is large difference, physician-to-nurse ratio is 1:1. 2, and the Gini coefficient is more than 0. 3. Equity in financing, health care spending per capita is less than the national level. Cities and counties with high government budgets for health are located in regional centers. The hospitalization costs compensation with new rural co-operative medical scheme is about 50%. Equity in service supply, bed occupancy rate below 90% and drugs accounted for 30% ~40% in most cities and counties. Regional differences in maternal and child health management are small, but below the national level. Conclusions:The situation of essential health care resources is related to the political and economic climate. Financing mechanisms for essential health care are imperfect;and a low supply of basic medical and public health services reduced the quality of essential health care. Suggestions:Rational distribution of essential health care resources should be promoted;essential health care financing should be increased;and the capability of essential health care supply should be improved.
