中国大都市区域医疗资源配置的均衡性及优化研究

Study on the Equilibrium and Optimization of Medical Resource Allocation in Metropolitan Areas: A Case Study of Shanghai

本文运用泰尔指数法和综合评价法,以上海为例分析了当前中国大都市区域医疗资源配置均衡性及变化状况。本文认为,从总体配置指标来看,医疗机构数提升比较明显,床位和卫计人员等资源提升不明显;从纵向配置指标来看,虽然医院层面和社区层面的医疗资源都在增加,但是倒三角配置格局更加严重。医院医疗资源配置的均衡性总体相对较差;社区医疗资源的配置均衡性相对较好,但由于所占有总体医疗资源有限,社区医疗资源仍然处于低水平的均衡。基于分析结果,本文建议在增量方面要适度增加优质资源的供给,补齐卫生人力资源短板;在存量方面要加大基层倾斜力度,推动医疗卫生资源从中心城区向郊区的合理流动;在机制层面充分利用智慧医疗等技术手段,促进医疗资源跨区域、跨层级、跨机构、跨时间的高效利用。

Using Theil index method and comprehensive evaluation method,this paper takes Shanghai as an example to analyze the changes of medical resources allocation in metropolitan areas since the new health reform. From the point of view of the overall allocation index,the number of medical institutions has increased obviously,while the resources such as beds and health care personnel have not increased significantly. From the perspective of vertical allocation indicators,although medical resources at the hospital level and community level are increasing simultaneously,the increase of medical resources at the hospital level is faster,and the inverted triangle allocation pattern is more serious. The overall balance of hospital medical resources allocation is relatively poor;the balance of community medical resources allocation is relatively good,but because of the limited overall medical resources,community medical resources are still in a low level of balance.Based on the analysis results,some suggestions are put forward from the aspects of medical resources stock,increment and efficiency. Firstly,we should increase the supply of high-quality resources appropriately and make up for the shortcomings of health human resources;secondly,we should increase the inclination of grassroots level to guide the vertical equalization of medical resources;finally,we should optimize the mechanism to improve the efficiency of the use of medical resources.