我国基层医疗资源配置失配度测算及其时空演变分析

Background  With the aging of the population and the increase of the proportion of patients with chronic diseasesthe people 's demand for primary medical resources is diversified and complicated. There are differences in the demand for primary medical resources among different regions and different groups of people. Some areas are facing the problem of lack of primary medical resourceswhich seriously restricts the coverage and quality of primary medical and health servicesand greatly affects the medical experience and health status of residents. Objective  In order to promote the high-quality development of the primary medical and health service systemthe health distance model is introduced to analyze the spatial and temporal evolution process of the allocation mismatch of primary medical resources in China from 2011 to 2021so as to provide reference for rationally formulating regional health plansoptimizing the allocation of medical resourcesimproving the capacity of primary medical and health servicesand promoting the high-quality development of medical and health services. Methods  An evaluation index system for the mismatch of primary medical resources was established from the three levels of health material resourceshuman resources and security resources. Data were obtained from the China Statistical Yearbook of China Health Statistics Yearbook. The bi-level programming model and the health distance model were used to measure the mismatch of primary medical resources allocation from 2011 to 2021. Results  From 2011 to 2021the overall mismatch degree of primary medical resources allocation in China has a significant downward trendbut the mismatch degree differences between regions and provinces continue to expand. The average values of mismatch in the easterncentral and western regions in 2011 were 0.6330.624 and 0.754respectivelywhich were moderate mismatchmild mismatch and severe mismatch. In 2021the average values of mismatch in the easterncentral and western regions are 0.4790.522 and 0.639respectivelywhich are moderate matchingmild matching and moderate mismatch. Conclusion  Promoting the expansion of high-quality medical resources and promoting the balanced layout of regional medical resources are the premise of building a high-quality and efficient medical and health service system. In order to further optimize the allocation of primary medical resources and improve China 's medical and health service systemwe should formulate reasonable macro policies in combination with the characteristics of each regionimprove the level of economic developmentoptimize the structure of fiscal expenditureimprove the administrative capacity of local governmentsreduce the mismatch of primary medical resources allocationand realize the high-quality development of primary medical and health service system.