基于fsQCA组态视角的我国全科医生资源配置公平性及影响路径研究

Study on the Equity and Influence Path of General Practitioner Allocation in China from the Perspective of fsQCA Configuration

目的:分析我国全科医生资源配置公平性及影响路径,为加快全科医生队伍建设提供参考。方法:使用卫生资源密度指数评价我国全科医生资源配置公平性,运用模糊集定性比较分析方法(fuzzy-set qualitative comparative analysis,fsQCA)分析影响全科医生资源配置公平性的路径。结果:2021年,我国东部、中部和西部地区的卫生资源密度指数分别为0.279、0.136、0.060,东部全科医生资源配置公平性优于中西部地区。影响全科医生资源配置公平性的核心条件是人口聚集度,高公平性组态共4条路径,总一致性为0.97,总覆盖度为0.82;低公平性组态共7条路径,总一致性为0.97,总覆盖度为0.76。结论:我国全科医生资源配置公平性的区域差异显著,多种复杂因素共同影响全科医生资源配置公平性,其中人口聚集度是直接影响因素,各种因素间的协同作用有助于实现全科医生资源配置高公平性。

Objective:To analyze the equity of general practitioner(GP)distribution across China and explore the pathways influencing regional disparities in this equity.The goal is to provide theoretical insights for the rapid development of the GP workforce.Methods:The health resource density index(HRDI)was employed to assess the equity of GP distribution in China.The fuzzy set qualitative comparative analysis method was used to identify the pathways affecting this equity.Results:In 2021,the HRDIs for the eastern,central,and western regions were 0.279,0.136,and 0.060,respectively,indicating a higher equity in GP distribution in the eastern region compared to the central and western regions.The analysis identified population density as the key factor influencing the equity of GP resource allocation.Four pathways were associated with high equity(total consistency:0.97;total coverage:0.82),and seven pathways with low equity(total consistency:0.97;total coverage:0.76).Conclusion:There are significant regional differences in the equity of GP resource allocation in China.Multiple complex factors influence this equity,with population density being a direct factor.The synergistic interaction among various factors facilitates the achievement of higher equity in GP resource allocation.