本文選題：社區(qū)衛(wèi)生資源配置 + 公平�。� 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究背景:分級診療被認(rèn)為是解決我國長久以來"看病難、看病貴"等問題的關(guān)鍵步驟,也是全面深化醫(yī)改的關(guān)鍵舉措。社區(qū)衛(wèi)生服務(wù)在提供基本醫(yī)療服務(wù)和基本公共衛(wèi)生服務(wù)中起著重要作用,是我國基層醫(yī)改中的重要組成部分,也是分級診療環(huán)節(jié)中基層首診的實(shí)現(xiàn)者。但隨著社區(qū)衛(wèi)生服務(wù)的開展,社區(qū)衛(wèi)生資源配置矛盾也日益凸顯,存在著分配不均與資源浪費(fèi)現(xiàn)象,導(dǎo)致社區(qū)居民醫(yī)療需求得不到滿足。因此,對社區(qū)衛(wèi)生資源配置的公平性及效率進(jìn)行分析,能有效反映我國社區(qū)衛(wèi)生資源配置與利用現(xiàn)狀,發(fā)現(xiàn)資源配置中存在的問題,從而為推進(jìn)分級診療順利進(jìn)行以及社區(qū)衛(wèi)生資源配置提供建議。研究目的:為應(yīng)對新的發(fā)展趨勢,本文從資源配置的公平和效率兩個(gè)角度,評價(jià)我國30個(gè)省市以及東中西部三大地區(qū)的社區(qū)衛(wèi)生資源利用及配置情況,發(fā)現(xiàn)社區(qū)衛(wèi)生資源配置中存在的問題,期望為社區(qū)衛(wèi)生資源配置提供建議。研究方法:先描述性分析2011-2015我國年社區(qū)衛(wèi)生資源配置與利用總體情況;然后運(yùn)用洛倫茨曲線、基尼系數(shù)以及泰爾指數(shù)對我國社區(qū)衛(wèi)生資源配置的公平性作出全面的分析;再從資源配置效率角度,運(yùn)用數(shù)據(jù)包絡(luò)分析模型,從橫向和縱向兩個(gè)時(shí)間維度對我國社區(qū)衛(wèi)生資源配置進(jìn)行分析,并將社區(qū)衛(wèi)生資源配置的全要素生產(chǎn)率進(jìn)行分解,進(jìn)一步分析影響效率的主要原因。研究結(jié)果:我國社區(qū)衛(wèi)生資源總體發(fā)展穩(wěn)定,但東中西部資源配置上存在一定差異;醫(yī)護(hù)比較低,社區(qū)衛(wèi)生人力資源的結(jié)構(gòu)還有待改善;社區(qū)衛(wèi)生資源配置按地理分布的公平性還需進(jìn)一步改善,地區(qū)內(nèi)差異是影響總差異主要原因;社區(qū)衛(wèi)生資源配置效率低,技術(shù)進(jìn)步有影響全要素生產(chǎn)率趨勢。研究結(jié)論:堅(jiān)持公平與效率的統(tǒng)一,統(tǒng)籌區(qū)域社區(qū)衛(wèi)生資源配置;大力推行分級診療,加強(qiáng)社區(qū)"基層首診";加強(qiáng)社區(qū)衛(wèi)生人才隊(duì)伍建設(shè);持續(xù)縮小社區(qū)衛(wèi)生資源配置地區(qū)內(nèi)部差異水平。
[Abstract]:Background: hierarchical diagnosis and treatment is regarded as a key step to solve the problem of "difficult and expensive to see a doctor" for a long time in China, and also a key measure to deepen medical reform in an all-round way. Community health service plays an important role in the provision of basic medical services and basic public health services. It is an important part of the basic medical reform in China, and it is also the implementer of the first diagnosis at the grass-roots level in the process of graded diagnosis and treatment. However, with the development of community health services, the contradiction of community health resources allocation has become increasingly prominent, there are uneven distribution and waste of resources, resulting in community residents' medical needs can not be met. Therefore, the analysis of the fairness and efficiency of the allocation of community health resources can effectively reflect the present situation of the allocation and utilization of community health resources in China, and find out the problems existing in the allocation of community health resources. So as to promote the classification of diagnosis and treatment smoothly and the allocation of community health resources to provide advice. Objective: in order to cope with the new development trend, this paper evaluates the utilization and allocation of community health resources in 30 provinces and cities of China and three regions in the east, west and west of China from the perspective of resource allocation fairness and efficiency. To find out the problems in the allocation of community health resources and to provide suggestions for the allocation of community health resources. Methods: firstly, the general situation of the allocation and utilization of community health resources in China from 2011 to 2015 was analyzed, and then the equity of the allocation of community health resources in China was analyzed by using Lorenz curve, Gini coefficient and Thiel index. Then from the perspective of resource allocation efficiency, using the data envelopment analysis model, this paper analyzes the allocation of community health resources in China from the horizontal and vertical time dimensions, and decomposes the total factor productivity of the allocation of community health resources. Further analysis of the main factors affecting efficiency. The results showed that the development of community health resources in China was stable, but there were some differences in the allocation of resources between east, west and west, and the structure of community health human resources needed to be improved. The fairness of the distribution of community health resources according to geographical distribution needs to be further improved, the regional differences are the main factors affecting the total differences, the efficiency of community health resources allocation is low, and the trend of total factor productivity is affected by technological progress. The conclusion of the study is: to insist on the unity of fairness and efficiency, to coordinate the allocation of regional community health resources, to vigorously carry out hierarchical diagnosis and treatment, to strengthen the "first diagnosis at the grass-roots level" in the community, to strengthen the construction of community health personnel; To reduce the level of community health resources allocation within the region.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1

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