上海郊区卫生资源配置和利用的公平与效率分析

Analysis of the Equity and Efficiency of Health Resource Allocation and Utilization in the Suburb of Shanghai.

目的 :通过对上海郊区卫生资源配置和利用的分析 ,指出卫生资源配置和利用中存在的公平和效率问题 ,并提出政策建议。方法 :对上海郊区不同经济发展时期和不同经济发展水平地区的比较分析。结论 :1.上海郊区政府对卫生事业经费的投入采取了一定的倾斜政策 ,公平性得到了相应提高 ,但三类地区人均卫生事业经费仍然较低 ;2 .上海郊区每千人口医生数和每千人口护士数较低 ,均低于全市的平均水平 ,尤其是三类地区 ;3.三类地区平均每人每年诊疗次数及每千人口每年住院次数相对较低 ;4 .上海郊区尤其是经济发展水平较低的地区医疗卫生服务利用效率较低。政策建议 :1.建立健全多种形式的医疗保障制度 ,提高医疗保障的社会化程度 ;2 .开展社区卫生服务 ,改革上海郊区医疗卫生服务功能 ;3.实施区域卫生规划 ,合理配置卫生资源 ;4 .大力加强卫生人才建设 。

Objectives Through analyzing allocation and utilization of health resource in the suburb of Shanghai to discuss the equity and efficiency of allocation and utilization of health resource and put forward policy suggestion. Methods. To Comparably analyze allocation and utilization of health resource by economy development periods and areas with different economy development levels. Conclusions. (1) The governments of suburb of Shanghai take some preferential policy in allocation of funds to health service and the equity is improved. However, allocation of funds to health service per capital is still low in the third type district; (2) the numbers of physicians and nursing staff per 1000 population are lower than the average level of whole city, especially in the third type district; (3) average visits per doctor per year and times of hospitalization per 1000 per year are comparably low in third type district; (4) the utilization of medical service is low in suburb of Shanghai, especially in districts with lower economy development level. Policy suggestions. (1) Establishing and perfecting multi-type medical insurance system and improving the socialization of medical insurance; (2) carrying out community health service and reforming medical service functions; (3) implementing regional health plan and reasonably allocating health resource; (4) strengthening construction of the health talent and improve the quality of medical service.