本文選題：衛(wèi)生資源 + 公平性　； 參考：《南京醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究的主要目標(biāo)是了解江蘇省某市近五年醫(yī)療衛(wèi)生資源配置的基本情況,對2010-2015年江蘇省某市醫(yī)療衛(wèi)生資源的配置狀況和衛(wèi)生服務(wù)利用情況進(jìn)行分析,評價醫(yī)療衛(wèi)生資源配置的合理性和公平性,提出優(yōu)化江蘇省某市醫(yī)療衛(wèi)生資源配置的政策建議,為衛(wèi)生行政部門優(yōu)化醫(yī)療衛(wèi)生資源配置提供科學(xué)的參考依據(jù),實(shí)現(xiàn)江蘇省某市醫(yī)療衛(wèi)生事業(yè)更好、更健康的發(fā)展。方法:通過文獻(xiàn)研究了解國內(nèi)外對醫(yī)療衛(wèi)生資源配置現(xiàn)狀及公平性研究進(jìn)展,構(gòu)建理論研究體系。通過描述性分析研究掌握江蘇省某市社會經(jīng)濟(jì)和人口健康狀況、醫(yī)療衛(wèi)生資源配置和醫(yī)療衛(wèi)生服務(wù)利用情況以及衛(wèi)生資源發(fā)展情況,總結(jié)江蘇省某市醫(yī)療衛(wèi)生資源配置特點(diǎn)。在此基礎(chǔ)上運(yùn)用基尼系數(shù)和泰爾指數(shù)兩種方法從常住人口分布和地理面積分布兩個維度對江蘇省某市的醫(yī)療衛(wèi)生機(jī)構(gòu)、床位、執(zhí)業(yè)(助理)醫(yī)師、注冊護(hù)士資源進(jìn)行公平性分析。結(jié)果:在資源配置方面,江蘇省某市近年來醫(yī)療資源總量不斷增加但資源分布不合理,大多數(shù)衛(wèi)生資源集中在中心城區(qū)和三級醫(yī)院,經(jīng)濟(jì)發(fā)展較為落后的周邊地區(qū)衛(wèi)生資源較少;基層醫(yī)療衛(wèi)生資源不足;醫(yī)護(hù)比例失衡。在公平性方面,按人口配置的基尼系數(shù)處于0～0.3之間,按地理配置的基尼系數(shù)處于0.3～0.6之間;按人口配置的泰爾指數(shù)處于0～0.3之間,按地理配置的泰爾指數(shù)處于0.1～0.5之間,江蘇省某市的醫(yī)療衛(wèi)生資源配置公平性逐年改善,按人口配置的公平性優(yōu)于按地理配置。在人口配置上,醫(yī)療衛(wèi)生機(jī)構(gòu)基尼系數(shù)在0～0.2之間,達(dá)到高度公平,其他均為比較公平;在地理配置上,除醫(yī)療衛(wèi)生機(jī)構(gòu)資源,其他醫(yī)療衛(wèi)生資源配置均不公平,不公平程度從大到小依次是床位資源、執(zhí)業(yè)(助理)醫(yī)師資源、注冊護(hù)士資源。結(jié)論:需要通過加強(qiáng)區(qū)域衛(wèi)生規(guī)劃、優(yōu)化衛(wèi)生資源配置、改善醫(yī)護(hù)比例、加大基層衛(wèi)生資源投入等方式來促進(jìn)江蘇省某市的醫(yī)療衛(wèi)生資源合理分布,提高居民對衛(wèi)生服務(wù)利用的公平性和可及性,滿足居民健康需求,促使江蘇省某市衛(wèi)生事業(yè)健康、可持續(xù)發(fā)展。
[Abstract]:Objective: the main objective of this study was to understand the basic situation of medical and health resources allocation in a certain city of Jiangsu Province in recent five years, and to analyze the allocation of medical and health resources and the utilization of health services in a certain city of Jiangsu Province from 2010 to 2015. To evaluate the rationality and fairness of the allocation of medical and health resources, and to put forward some policy suggestions for optimizing the allocation of medical and health resources in a certain city of Jiangsu Province, and to provide a scientific reference basis for the administrative departments of health to optimize the allocation of medical and health resources. To achieve a city in Jiangsu Province better health care, more healthy development. Methods: to study the status quo and equity of medical and health resources allocation at home and abroad through literature study, and to construct a theoretical research system. Through descriptive analysis, the author grasped the social economy and population health status, the allocation of medical and health resources, the utilization of medical and health services and the development of health resources in a certain city of Jiangsu Province, and summarized the characteristics of the allocation of medical and health resources in a certain city of Jiangsu Province. On this basis, Gini coefficient and Tyr index are used to analyze the medical and health institutions, beds and assistant doctors in a certain city of Jiangsu Province from the two dimensions of resident population distribution and geographical area distribution. The fairness of registered nurse resources was analyzed. Results: in terms of resource allocation, the total amount of medical resources in a certain city of Jiangsu Province has been increasing in recent years, but the distribution of resources is unreasonable. Most of the health resources are concentrated in the central urban area and tertiary hospitals. There are less health resources in peripheral areas with backward economic development, insufficient primary medical and health resources, and unbalanced health care ratio. In terms of equity, the Gini coefficient of population allocation is between 0 and 0.3, that of geographical allocation is between 0.3 and 0.3, and that of population allocation is between 0 and 0.3. The Taier index of geographical allocation is between 0.1 and 0.5, and the fairness of allocation of medical and health resources in a certain city of Jiangsu Province is improved year by year, and the fairness of allocation by population is better than that by geography. In terms of population allocation, the Gini coefficient of medical and health institutions was between 0 and 0.2, which reached a high degree of equity, while the rest were fairly equitable. In terms of geographical allocation, the allocation of other medical and health resources, except for medical and health institutions, was not fair. The unfair degree from big to small is bed resources, practicing (assistant) doctors resources, registered nurses resources. Conclusion: it is necessary to promote the rational distribution of medical and health resources in a certain city of Jiangsu Province by strengthening regional health planning, optimizing the allocation of health resources, improving the proportion of medical care and medical care, and increasing the input of primary health resources. To improve the fairness and accessibility of the utilization of health services, to meet the health needs of residents, and to promote the healthy and sustainable development of a city in Jiangsu Province.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1

【參考文獻(xiàn)】

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本文編號：2012689