医疗机构卫生资源供给结构与医疗费用增长关系研究:基于福建省数据

Research on the relationship between supply structure of health resources and growth of medical expenses in medical institutions from supply perspective: based on data from Fujian province

目的对比不同类型医疗机构床位及人员等卫生资源供给结构差异,分析卫生资源供给结构对医疗费用增长的影响程度与方向。方法通过聚类分析法,对福建省卫生资源指标进行聚类;利用层次回归模型,估计人口、社会经济、卫生资源供给结构等因素对医疗费用增长的影响程度。对所有样本数据取对数处理,消除不同指标计量单位对分析结果的影响。结果卫生资源指标聚为基础性和优质性卫生资源指标两类。人均国内生产总值对人均住院费用具有正向影响(β=0.228,P<0.05),基础性床位数对人均住院费用存在显著负向影响(β=-0.719,P<0.001);基础性床位配置的增加对降低人均住院费用效果显著,但优质卫生资源的回归结果总体上不够显著。结论从供给侧改革政策角度来看,卫生资源供给结构应与医疗费用增长水平相适应。加强对医疗费用的控制,未来政府应更多地强化在卫生资源投入选择和目标方面的针对性,确保医疗卫生可持续健康发展。

Objective To compare such supply structure differences of health resources as number of beds and manpower at medical institutions of different types, and to analyze the extent and direction of the health resources supply in affecting the growth of medical expenses. Methods Clustering analysis was used to cluster health resources indicators in Fujian province. The hierarchical regression model was used to estimate the impact of such factors as population, social economy and health resource supply structure on medical cost growth. All the sample data were logarithmically processed to eliminate the influence of different index measurement units on the analysis results. Results The clustering indicators of health resources were classified into two categories: basic and quality health resources indicators. The per capita GDP had a positive impact on the per capita total hospital expenses(β=0.228, P<0.05), and the number of basic beds had a negative impact on the per capita total hospital expenses(β=-0.719, P<0.001). The increase in basic bed allocation had a significant effect on reducing the total cost of hospitalization per capita, but the regression results of quality health resources were generally not significant. Conclusions From the perspective of supply-side reform policy, the supply structure of health resources should be in line with the growth level of medical expenses, and the control of medical expenses should be strengthened. The government should strengthen the pertinence in the selection and target of health resource investment to ensure the sustainable and healthy development of health care.