卫生健康服务水平统计测度及影响因素分析

Statistical Measurement of Health Service Level and Influencing Factors

新医改背景下,提升卫生健康服务水平是推进健康中国建设的有效途径之一。依据卫生健康服务水平统计测度指标体系和中国31个省级面板数据,研究中国卫生健康服务水平及其影响因素,结果显示:中国卫生健康服务水平呈阶段式“上升—下降—上升”的“N”型波动趋势,截面差异显著,其系统聚类为五个类别,2010年以来,中国卫生健康服务水平均有不同程度的波动;不同地区卫生健康服务水平高低次序为:东部>中部>东北>西部,区域非均衡性特征明显,东部、中部、东北和西部分别呈现平稳提升、波浪式上升、波浪式下降和平稳发展的波动特征;仅妇幼保健水平呈现平稳提升的发展态势,各省市区妇幼保健水平均高于其他子系统;医疗卫生投入占比、财政支出、财政收入、医疗保障、城镇化水平和电信业务总量等均能促进卫生健康服务水平的提升,而医疗消费指数、人均地区生产总值和人口密度的作用相反。该结果可为优化卫生健康服务管理提供经验依据。

Based on the statistical measurement index system of health service level and panel data from 31 provinces in China,this study investigates the level of health service in China and its influencing factors.The results show that the level of health service in China shows a“N”-shaped fluctuation trend of“rising falling rising”in stages,with significant cross-sectional differences.The system is clustered into five categories,and since 2010,the level of health service in China has fluctuated to varying degrees;The order of the level of health services in different regions is as follows:East>Central>Northeast>West.The regional imbalance is obvious,and the East,Central,Northeast,and West respectively show fluctuating characteristics of“steady improvement”,“wave like rise”,“wave like decline”,and peaceful development;Only the level of maternal and child health has shown a steady improvement in development,and the level of maternal and child health in each province is higher than that of other subsystems;The proportion of medical and health investment,fiscal expenditure,fiscal revenue,medical security,urbanization level,and total telecommunications business can all promote the improvement of health service level,while the effects of medical consumption index,per capita regional GDP,and population density are opposite.This result can provide empirical basis for optimizing the management of health services.