大型医用设备配置规划与配置许可证制度的政策评价

Evaluating the Policy of High Technology Medical Equipment Allocation,Planning and Certificate of Need

目的对我国自2005年实行至今的大型医用设备配置规划和配置许可证制度进行评价,为卫生计生部门制定相关政策提供依据。方法从我国东、中、西部各选择1个省作为研究的样本,通过向各省卫生行政部门发放调查问卷的形式收集相关资料,进行定量分析。结果总体上,3个样本省CT和MRI配置数量年同比增长率都呈下降趋势,配置规划和配置许可证政策实施后的年均增长率也明显要比实施前低。政策实施后3个样本省CT和MRI人口和地理分布的基尼系数都有不同程度的下降。总体上CT配置的公平性要好于MRI配置的公平性,资源人口分布的公平性要好于地理分布的公平性。结论我国大型医用设备配置规划和配置许可证制度对于控制设备过快增长和提升设备配置的公平性都起到积极的作用,但在不同地区以及对于不同的设备,政策效果不一样。

Objective The study aims to evaluate the allocation, planning and certificate of need（CON） policy of high technology medical equipment and to provide evidence for improving the policy. Methods Six provinces located in the east,middle and west regions in our country were selected as the study sample,and key information were obtained from the provincial departments of health through a questionnaire survey. Results The year on year growth rates of CT and MRI had decreasing trends and the average annual growth rates of these two types of equipment were lower after the policy implementation. After the policy implementation,the equity in CT and MRI distribution was improved as indicated by the reduced Gini coefficients. But the reduction was bigger for MRI. The reduction also varied across populations and geographic regions. Conclusion The allocation, planning and CON policy of high technology medical equipment helps control the fast growth rate and improving the fair distribution of high technology medical equipment,while the effects differ by region,population,and type of equipment.