新医改前后我国中医类医院医疗卫生资源配置变化研究

Analysis on the Changes of Medical and Health Resource Allocation in Chinese Traditional Medicine Hospitals before and after the New Medical Reform

目的:通过分析新医改前后我国中医类医院医疗卫生资源规模变化特点以及在不同地区之间资源配置公平性变化情况,探究新医改政策实施对中医药发展的影响。方法:将新医改前后分两个时间阶段,对中医类医院医疗卫生资源的发展速度及占比变化情况进行对比分析,对区域资源配置公平性的变化情况利用集中指数和泰尔指数分析。结果:新医改后,2008—2018年机构数、床位数、卫生技术人员和中医执业(助理)医师的年均增速分别为4.72%、10.21%、8.53%和8.26%;中医类医院机构数、床位数和卫生技术人员数的占比不足20%,中医执业(助理)医师数占比在30%左右;新医改后2018年机构数、床位数、卫生技术人员和中医执业(助理)医师的集中指数分别是-0.047、-0.010、0.051和0.063。结论:新医改政策实施对中医药发展成效显著;新医改后,中医药医疗卫生资源占全国的比例仍然较低;区域资源配置公平性总体较好,但区域内差异较大;卫生人力资源配置依然集中在经济水平较高的地区。

Objective:By analyzing the characteristics of changes in the scale of medical and health care resources in TCM hospitals before and after the new medical reform,and the changes in the equity of resource allocation among different regions,it explores the impact of the new medical reform policy on the development of traditional Chinese medicine.Methods:The new medical reform is divided into two time periods so as to take a comparative analysis of the development speed and proportion of medical and health resources in TCM hospitals.The changes in the equity of regional resource allocation are analyzed by using the concentration index and Theil index.Results:After the new medical reform,the average annual growth rate of the number of institutions,the number of beds,health technicians and practitioners of traditional Chinese medicine(assistant)physicians during 2008—2018 are 4.72%,10.21%,8.53%and 8.26%.The proportion of the number of institutions,beds and health technicians are less than 20%,and the number of practitioners of traditional Chinese medicine(assistant)physicians accounts for about 30%.The concentration index of the number of institutions and beds,the health technicians and the practicing(assistant)physicians of traditional Chinese medicine are-0.047,-0.010,0.051,and 0.063 in 2018.Conclusion:The new medical reform policy has made remarkable achievements in the development of traditional Chinese medicine.After the new medical reform,the proportion of TCM medical and health resources is still low.The equity of regional resource allocation is generally good,but the regional differences are large.The allocation of human resources for health is still concentrated in areas with higher economic levels.