摘要
目的:根据协调发展理论构建社会经济与卫生资源投入协调发展评价指标体系,探索我国各省(自治区、直辖市)社会经济发展与卫生资源投入的相互作用及其与健康水平的关系。方法:采用熵权法计算社会经济与卫生资源各项指标权重,利用协调发展度模型对我国31个省(自治区、直辖市)的社会经济与卫生资源的协调发展水平进行地区差异分析和纵向动态分析。结果:(1)2010—2018年,不同省(自治区、直辖市)社会经济和卫生资源各项指标权重出现变化,整体特征发生改变。(2)2012—2018年,东、中部社会经济与卫生资源差距不断增加,西部差距减小。(3)地区分布上,大部分省(自治区、直辖市)协调发展度在0.40~0.59之间,属于过渡发展类。纵向发展上,2010年的协调发展度最高,后8年间先下降后上升,但贵州、青海、宁夏、西藏、海南边远地区协调发展度在逐年上升。(4)围产儿死亡率和孕产妇死亡率与协调发展度呈现一定的负向关系,在中部和西部表现更加明显。结论:我国31个省(自治区、直辖市)整体协调发展水平一般,中部协调发展度较高,东部和西部协调发展度的内部差异较大;协调发展度对健康水平有一定的解释力度。需进一步调整卫生资源投入,提高精准性和动态性;关注区域间卫生服务的交互需求,改善卫生资源投入公平性。
Objective:To construct an evaluation index system for the coordinated development of socio-economy and health resource input based on coordinated development theory,and to explore the interaction between social economic development and health resources allocation in various provinces in China and its relationship with health during the period from 2010 to 2018.Methods:Entropy weight method was used to calculate the weights of indicators of social economy and health resources,and the coordinated development degree model was employed to analyze the regional differences and longitudinal dynamics of the coordinated development level of social economy and health resources in 31 provinces.Results:(1)The weights of various social economic development and health resources allocation indicators in different provinces(cities)changed,and the overall characteristics changed.(2)The gap between social economic development and health resources allocation continued to increase in the eastern and central regions,and decreased in the western region.(3)In terms of regional distribution,the coordinated development degree of most provinces(cities)is between 0.40 and 0.59,which belongs to the transitional development category.The coordinated development degree of Hebei,Henan,Shandong,Hunan,and Sichuan is greater than 0.60,which belongs to the category of good coordinated development.In terms of vertical development,the degree of coordinated development peaked in 2010,and then declined first and rose again during the next eight years.However,the degree of coordinated development in remote areas of Guizhou,Qinghai,Ningxia,Tibet,and Hainan is increasing year by year.(4)The perinatal mortality rate and maternal mortality rate show a certain negative relationship with the degree of coordinated development,which is more obvious in the central and western regions.Conclusions:The overall level of coordinated development in 31 provinces is average,the level of coordinated development in the central region is relatively high,and the internal difference between the level of coordinated development in the eastern and western regions is relatively large.The level of coordinated development can explain the level of health quality to some extent.It is necessary to further adjust the health resources allocation policy in order to improve the accuracy and dynamics.Much attention should be paid to the interactive needs of healthcare services between regions,and the HRA equity should be improved.
作者
谭敏
苏岱
张云钒
雷诗寒
陈迎春
TAN Min;SU Dai;ZHANG Yun-fan;LEI Shi-han;CHEN Ying-chun(School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei 430000, China;Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan Hubei 430000, China)
出处
《中国卫生政策研究》
CSCD
北大核心
2021年第4期18-27,共10页
Chinese Journal of Health Policy
基金
国家自然科学基金面上项目(71673101)。
关键词
经济
社会
卫生资源
熵权法
协调发展度
Economy
Society
Health resources
Entropy weight method
Coordinated development degree
