摘要
目的:比较我国新医改前后医疗卫生机构收入与支出的空间分布变化情况,为改善区域性医疗服务平衡发展提供科学参考.方法:整理我国医疗卫生机构收入支出的各年度数据,利用ArcGIS 10.2软件对该数据进行空间自相关分析.结果:2007—2016年(除2015年外),收入、支出的全局Moran's I指数均为正值,差异有统计学意义(P<0.05),且在2010年后减弱.局部自相关分析显示,东部省份为收支热点聚集区,西部省份为冷点聚集区,十年间聚集地区明显减少.截止到2016年,收支冷点区域减少了甘肃、四川,仅剩新疆,热点区域减少了福建、浙江、江西,仅剩江苏、上海、山东、安徽.结论:省际医疗卫生机构收支差距悬殊,新医改之后有缩小趋势.医疗卫生机构收入、支出存在空间聚集性,表现为高收入(支出)省份毗邻,低收入(支出)省份毗邻.新医改之后空间自相关性呈减弱趋势,且冷热点聚集区域均明显减少,医疗卫生区域平衡发展初见成效,区域卫生服务利用公平性有所提升.
Objective: To compare the spatial distribution of medical and health institutions' income and expenditure before and after the new medical reform in China, in order to provide scientific references for improving the balanced development of regional medical services. Methods: It sorted out the annual data of the medical and health institutions' income expenditure in China, and used ArcGIS 10.2 Software to analyze the spatial autocorrelation of the data. Results: In 2007一20 16 (except 2015), the overall Moran's I index of income and expenditure was positive, which was statistically significant(P<0.05, Z >1.96), and weakened after 2010. Spatial autocorrelation showed that the eastern provinces were the hotspots for the income and expenditure, and the western were the cold. Up to 2016, the cold spot area had been reduced to Gansu and Sichuan, while Xinjiang remained. The hotspots reduced Fujian, Zhejiang, and Jiangxi, while Jiangsu, Shanghai, Shandong and Anhui remained. Conclusion: Provincial medical and health institutions had a disparity in income and expenditure, and there was a narrowing trend after the new reform. The data were spatially clustered, showing the high income (expenditure) provinces adjacent to each other and low-income (expenditure) provinces adjacent. After the new medical reform, the spatial autocorrelation was weakened, and the cold hot spot gathering area was significantly reduced. The balanced development of the medical and health areas was initially effective, and the equity of regional health service utilization was improved.
作者
姜鑫洋
盛红旗
李旭
马桂峰
仇蕾洁
马安宁
JIANG Xinyang;SHENG Hong-qi;LI Xu(School of Public Health and Management, Weifang Medical University, Weifang, Shandong, 261053, China)
出处
《中国卫生经济》
北大核心
2019年第6期33-36,共4页
Chinese Health Economics
基金
国家自然科学基金项目(71673202)
山东省研究生导师指导能力提升项目(SDYY17104)
关键词
医疗卫生机构
收入与支出
空间分布
health care institution
income and expenditure
spatial distribution
