本文選題：泰爾指數(shù) + 基尼系數(shù)��； 參考：《海南師范大學》2016年碩士論文

【摘要】：衛(wèi)生服務公平性是世界衛(wèi)生組織對各國衛(wèi)生服務績效評估的一個重要指標,而衛(wèi)生資源配置公平性是衛(wèi)生服務公平性的前提。如何使衛(wèi)生資源公平且有效地在不同的領域、人群、項目中分配,從而實現(xiàn)衛(wèi)生資源的社會和經(jīng)濟效益最大化是各界關注的熱點問題。2009年國家《關于深化醫(yī)藥改革衛(wèi)生體制的意見》中明確指出,要充分優(yōu)化整合配置現(xiàn)有衛(wèi)生資源,促進基本公共衛(wèi)生服務逐步均等化,可見醫(yī)療衛(wèi)生資源配置的公平性的重要程度。本文通過分析海南省衛(wèi)生資源配置現(xiàn)狀,系統(tǒng)評價衛(wèi)生資源配置公平性,探討各類衛(wèi)生資源配置在公平性方面存在的問題,為促進海南省衛(wèi)生事業(yè)持續(xù)、協(xié)調(diào)、穩(wěn)定的發(fā)展提供理論依據(jù)和方法支持。本研究采用統(tǒng)計描述方法對海南省衛(wèi)生資源現(xiàn)狀進行分析;利用基尼系數(shù)和泰爾指數(shù)對海南省各類衛(wèi)生資源按人口分布、地理分布公平性進行分析與評價;同時,構(gòu)建醫(yī)療衛(wèi)生資源配置指標體系,提出達標度和均衡度概念,并利用相對誤差距離和熵值法相結(jié)合,得出與醫(yī)療體系配套的指標權重,并利用多屬性決策方法對海南省18個市縣進行綜合評價。研究結(jié)果顯示:2009 2013年期間,海南省衛(wèi)生資源配置數(shù)量和質(zhì)量不斷提升,但每千人口衛(wèi)生資源占有量較低。2012年,除每千人口衛(wèi)技人員和注冊護士比全國平均水平高之外,其余各類衛(wèi)生資源人均占有量仍低于全國平均人均水平;衛(wèi)生資源配置數(shù)量是經(jīng)濟發(fā)達地區(qū)占優(yōu),且這五年期間不同經(jīng)濟發(fā)展地區(qū)的人均醫(yī)療衛(wèi)生資源擁有量的差距沒有變化;海南省衛(wèi)生資源配置按人口分布的公平性不斷提高,而按地理位置的公平性沒有太大變化,且基尼系數(shù)顯示的結(jié)果是按人口分布的衛(wèi)生資源分配公平性好于按地理分布的衛(wèi)生資源分配公平性,其中各類衛(wèi)生資源的人口分布基尼系數(shù)都在0.3以下,公平性都處于最佳狀態(tài),而衛(wèi)生技術人員、床位、醫(yī)師和護士按地理分布的基尼系數(shù)都高于0.4,公平性處于警戒狀態(tài);地區(qū)的經(jīng)濟發(fā)展對醫(yī)療衛(wèi)生資源配置有很大的影響,衛(wèi)生資源配置的水平會隨著經(jīng)濟地不斷發(fā)展而提高,地區(qū)經(jīng)濟發(fā)展的水平不同,其醫(yī)療衛(wèi)生資源的配置公平性情況也各不相同,經(jīng)濟發(fā)達地區(qū)和中等發(fā)達地區(qū)內(nèi)部醫(yī)療衛(wèi)生資源配置的均衡性比較好,而欠發(fā)達地區(qū)內(nèi)部醫(yī)療衛(wèi)生資源配置的均衡性較差;不同經(jīng)濟發(fā)展地區(qū)之間除了衛(wèi)生機構(gòu)之外的醫(yī)療衛(wèi)生資源配置差異縮小,但區(qū)域之間的非均衡性仍是造成海南省衛(wèi)生資源配置不均衡的主要原因;從達標度的角度來分析海南省衛(wèi)生資源的分配,發(fā)現(xiàn)海南省的平均達標度相對較低,利用多屬性決策方法對海南省各市縣醫(yī)療衛(wèi)生配置進行綜合評價,發(fā)現(xiàn)海南省在各市縣衛(wèi)生資源的分配、投入問題上存在一些不合理之處,各市縣的整體醫(yī)療衛(wèi)生資源配置相差懸殊。
[Abstract]:The equity of health service is an important indicator of health service performance evaluation in the world health organization, and the equity of health resource allocation is the premise of health service fairness. How to equitably and effectively distribute health resources across different areas, people, projects, Therefore, to maximize the social and economic benefits of health resources is a hot issue concerned by all circles. It is clearly pointed out in the National opinion on deepening the Reform of the Health system in 2009 that it is necessary to optimize and integrate the existing health resources. To promote the equalization of basic public health services, we can see the importance of fairness in the allocation of medical and health resources. By analyzing the present situation of health resources allocation in Hainan Province, this paper systematically evaluates the equity of health resources allocation, and discusses the problems existing in the fairness of all kinds of health resources allocation, in order to promote the continuity and coordination of health services in Hainan Province. The steady development provides the theoretical basis and the method support. This study uses the statistical description method to analyze the current situation of health resources in Hainan Province; uses Gini coefficient and Thiel index to analyze and evaluate the distribution of all kinds of health resources in Hainan Province according to the population distribution and the fairness of geographical distribution; at the same time, The index system of medical and health resources allocation is constructed, the concepts of standard degree and equilibrium degree are put forward, and the index weights matching with medical system are obtained by combining the relative error distance and entropy method. The multi-attribute decision-making method is used to evaluate 18 cities and counties in Hainan province. The results of the study show that the quantity and quality of health resources allocation in Hainan Province increased continuously during the period between 2009 and 2013, but the amount of health resources per 1,000 people was relatively low. In 2012, except for health professionals and registered nurses per 1,000 people, the level of health resources was higher than the national average. The per capita possession of other kinds of health resources is still lower than the average per capita level of the whole country, the allocation of health resources is dominant in the economically developed regions, and the difference of the per capita medical and health resources in different economic development areas has not changed during these five years. The fairness of the distribution of health resources according to the population in Hainan Province has been continuously improved, but the fairness of the distribution according to geographical location has not changed much. The result of Gini coefficient is that the fairness of distribution of health resources by population is better than that by geographical distribution, and the Gini coefficient of population distribution of all kinds of health resources is below 0.3. Fairness is in the best condition, and the Gini coefficient of health technicians, beds, doctors and nurses according to geographical distribution is higher than 0.4, and fairness is on the alert; the economic development of the region has a great impact on the allocation of medical and health resources. The level of allocation of health resources will increase with the continuous development of economy. The level of regional economic development varies, and the fairness of the allocation of medical and health resources varies from region to region. The balance of medical and health resources in the economically developed areas and the moderately developed areas is better than that in the less developed areas. The difference in allocation of medical and health resources between different economic development areas except health institutions is reduced, but the imbalance between regions is still the main reason for the imbalance of health resources allocation in Hainan Province. The distribution of health resources in Hainan Province is analyzed from the point of view of reaching the standard. It is found that the average standard degree of Hainan Province is relatively low. The multi-attribute decision-making method is used to comprehensively evaluate the medical and health allocation of each city and county in Hainan Province. It is found that there are some unreasonable problems in the allocation and investment of health resources in all cities and counties in Hainan Province, and there are great differences in the overall allocation of medical and health resources among the cities and counties.
【學位授予單位】：海南師范大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R197.1

【參考文獻】

相關期刊論文 前10條

1 賀買宏;王林;賀加;\租，

本文編號：2111541