我国省域医疗卫生机构运行规模、质量和效率的耦合协调度研究

Study on the Coupling Degree of Operation Scale,Quality and Efficiency of Provincial Medical and Health Institutions in China:TOPSIS Method Based on Entropy Weight and Coupling Coordination Degree Model

目的:分析评价我国省域医疗卫生机构运行规模、质量和效率的耦合协调度,促进卫生系统各要素协调发展,提升整体绩效水平。方法:从医疗卫生机构运行规模、质量和效率3个维度构建省域医疗卫生机构服务能力的指标体系,运用熵权TOPSIS法确定指标权重和能力指数,并基于耦合协调度模型评价2010-2019年我国31个省份医疗机构的耦合协调度。结果:我国医疗卫生机构的耦合协调度整体表现为由“失调”向“协调”演化,省际差距逐渐缩小。2019年,医疗卫生机构耦合协调性整体处于初级协调阶段,有90.32%的省份(28个省份)达到协调水平以上,但优质协调的省份一直空缺。结论:我国医疗卫生机构耦合协调总体水平不断提升,但是存在地区差异,医疗机构服务能力协调性短板不同且阻力因素各异。

Objective:To analyze and evaluate the coupling degree for operation scale,quality and efficiency of provincial medical and health institutions in China,promote the coordinated development of various elements of the health system,and improve the overall performance level.Methods:The service capability index system of provincial medical and health institutions is constructed from the the dimensions of operation scale,quality and efficiency of medical and health institutions.Entropy weight TOPSIS method is applied to determine the index weight and capability index,and evaluate the coupling coordination of medical institutions in 31 provinces in China from 2010 to 2019 based on the coupling degree model.Results:The overall performance of the coupling coordination of medical and health institutions in China is the evolution from"imbalance"to"coordination",and the provincial gap is gradually narrowing.In 2019,the overall coupling and coordination of medical and health institutions was in the primary coordination stage,and90.32%of the provinces(28 provinces)reached the coordination level,but the provinces with high-quality coordination remained vacant.Conclusion:The overall level of coupling and coordination of medical and health institutions in China continues to improve,but there are regional differences,different short boards of coordination of service capacity of medical institutions and different resistance factors.It is needed to deal with the relationship among the operation scale,quality and efficiency of medical and health institutions,and further improve the coupling and coordinated development level of medical and health institutions in China by improving the mechanism design and optimizing the system supply.