城乡基本医疗卫生服务均等化评价指标研究及实证分析

Research on assessment indicators of equalization of basic medical and health services in urban and rural areas

目的构建城乡基本医疗卫生服务均等化评价理论系统模型及指标体系，为推进建立覆盖城乡居民的基本医疗卫生制度建设提供理论及实证依据。方法采用综合文献分析法、Delphi法构建评价指标与模型，运用极值标化、医疗资源地理分摊、Gini系数等方法对东部某省会H市进行实证检验分析。结果构建了包括机会、过程、结果3个维度，政府筹资、资源配置、服务可及性等7个二级和27个三级城乡基本医疗卫生服务均等化评价指标体系。经计算，2010年H市城乡区域指标总均值为63．53，城乡均值分别为74．75、45．58。结论评价指标注重基本公共卫生与基本医疗服务、服务供给与需求、服务数量与质量的结合，为探究城乡基本医疗卫生服务均等化评价及政策制定者提供参考和借鉴。

Objective To build the theoretical system model and research assessment indicators for equalization of basic medical and health services of both urban and rural residents. This aims at providing a theoretical and empirical basis for advancing basic medical health system covering rural and urban residents. Methods Literature research and Delphi expert consultation are used to build the indicator model and structure. The extremal standard method, health resources sharing by geography method, Gini coefficient method and other statistical analysis were used for an empirical analysis and test in an eastern provincial capital city. Results The indicator system comprises three dimensions of opportunity, process and result, as well as seven second-level indicators of health financing, resource allocation, accessibility etc. and twenty-seven third-level indicators. The grand mean value of the urban and rural regional indicators for H city in 2010 was calculated as 63.53, while the mean values for urban and rural were 74. 75 and 45.58 respectively. Conclusion The assessment indicators focus on three combinations., basic public health services and basic medical services, service supply and demand, as well as the number and quality of services. This approach can help with the assessment of equalization of basic medical and health service for urban and rural areas and policy making.