基于多元回归-灰色模型的天津市卫生资源配置预测研究

Prediction of Tianjin health resources based on multiple regression-gray model

目的了解天津市卫生服务资源的发展趋势,为有关决策部门提供客观可行的对策建议。方法该研究数据来源于天津市统计年鉴,调取2006—2020年医院、基层医疗卫生机构、床位、卫生技术人员、执业(助理)医师、注册护士、人均卫生费用、政府卫生支出占比以及个人卫生支出占比9个指标的相关数据,采用Excel 2013软件构建多元回归模型,用MATLAB R2010b软件构建灰色模型及多元回归-灰色模型,进而预测2018—2020年各指标的预测值并与当年真实数据相检验评价模型。利用最佳模型对2021—2025年天津市卫生资源各指标进行预测。结果多元回归-灰色组合模型中每个指标的平均绝对百分误差(MAPE)均小于或等于任一单一模型,整体预测效果良好,预测精度优于单一的多元回归模型和灰色模型。利用多元回归-灰色组合模型进行预测,预计2021—2025年天津市医院最高可达到531家,基层医疗卫生机构最高可达到6571家,床位数最高可达到77094张,卫生技术人员、执业(助理)医师及注册护士数量最高可分别达到143226、64750和51590人,人均卫生总费用可达到8820.5元,政府卫生支出占比在21.7%~24.7%之间波动,个人的卫生支出占比在28.0%~29.0%之间波动。结论多元回归-灰色模型对天津市卫生服务资源整体预测更具有实用价值。天津市应继续加快发展基层医疗服务与卫生服务体系建设,优化医疗机构人才结构,积极扩宽卫生资金投入来源渠道和筹资结构。

Objective To understand the development trend of health service resources in Tianjin,and provide the objective and feasible countermeasures and suggestions for relevant decision-making departments.Methods The data were from the statistical yearbook of Tianjin,including the hospitals,grass-roots medical and health institutions,beds,health technicians,licensed(assistant)doctors,registered nurses,per capita health expenses,the proportion of government health expenditure and the proportion of individual health expenditure from 2006 to 2020.The multiple regression model is constructed by Excel 2013.The gray models and multiple regression gray models were constructed by MATLAB R2010b software.The predicted values of various indicators from 2018 to 2020 were predicted,and the actual data in same years were used to test the evaluation model.The best model was used to predict the indicators of health resources in Tianjin from 2021 to 2025.Results The average absolute percentage error(MAPE)of each index in the multiple regression gray combined model was less than or equal to that of any single model,and the overall prediction effect was better,and the prediction accuracy was better than that of the single multiple regression model and gray model.The multiple regression gray combination model was used for predicting.It was estimated that from 2021 to 2025,the maximum number of hospitals in Tianjin could be 531,the maximum number of primary medical and health institutions could be 6571,the maximum number of beds could be 77094,the maximum number of health technicians,licensed(assistant)doctors and registered nurses could be 143226,64750 and 51590,respectively;the total per capita health expenditure could be 8820.5 yuan,and the proportion of government health expenditure fluctuated between 21.7%and 24.7%;the proportion of individual health expenditure fluctuated between 28.0%and 29.0%.Conclusion The multiple regression gray model has more practical value for the overall prediction of health service resources in Tianjin.Tianjin should continue to accelerate the development of grass-roots medical services and health service system,to optimize the talent structure of medical institutions,and to actively expand the source of health capital investment and financing structure.