Research On Fair Space Of Health Service Under The Hybrid And Grading Treatment System In China Based On Accessibility During The Transitional Period

Since the reform and opening up in China,with the development of society and the improvement of people’s living quality,people pay more and more attention to the quality of life and health.As the basis of the protection of people’s health,the equity of medical and health service has great significance on ensuring that residents enjoy basic health rights,regulate social equity and justice,promote the sustainable development of medical and health undertakings and build a harmonious society.However,due to the concentration and scale of medical service resources,the prominent spatial differentiation between medical service resources and residential space,the medical and health resources administration "division",different social groups have an inequity opportunities to enjoy the medical health resources.Therefore,how to ensure the effective supply and reasonable allocation of medical and health service resources,allow the different social groups enjoy the medical and health services fairly,and improve China’s health service fairness is an urgent problem to solve.Based on the existing research at home and abroad,combining the theory and practice,choosing general hospitals(including no grade hospitals and grade hospitals)as the research object,by means of GIS,based on the perspective of supply and demand,we analyzed the spatial distribution characteristics of medical and health service supply in transition period of China under the county and district space scale.Based on county-level administrative region,from the perspective of accessibility,we researched fair space of the medical and health service under the hybrid and grading treatment system in China.When the spatial difference of accessibility is the smaller,the fair space of the medical and health services is higher,and vice versa.Then,we comparative analyzed the fair space of the medical and health services under the hybrid and grading treatment system before and after implementing "gain health service trans-regional",and put forward relevant suggestions.The full text is divided into six chapters,a total of three parts.The first part is the basis of this study,including the first three chapters,the first chapter is introduction(research reason,research starting point and research overview),and the third chapter is about the medical and health services of China and its spatial distribution situation.The first chapter and the third chapter is the realistic basis of this study,the second chapter is about related concepts and theory is the theoretical basis of this study;The second part is the empirical part of this paper,including the fourth chapter which is about analysis on fair space of the medical and health services under the hybrid diagnosis and hierarchical diagnosis system based on the county-lever and the fifth chapter which is about analysis on fair space of the medical and health services under the "gain health service trans-regional" mode.The third part is the conclusion of this article.The main conclusions are as follows:(1)Research on the current statistics shows that the spatial distribution consistency between the health services and population has a high level of growth,the spatial matching degree showed a trend of gradually enhanced.The overall difference of the medical service level decreased slowly in China,and the "highland phenomenon" and "depression phenomenon" of the medical and health services level is insignificant.The number of high level clustering areas of the medical and health services per capita has undergone a process of first decreasing and then increasing.The center of their spatial distribution has moved to west firstly and then to east of China.The overall number in low value clustering areas has presented continuous increase trend.The center of their spatial distribution has moved to east and then to west of China.Changes in spatial pattern have reduced the imbalance of medical and health services level.The imbalanced development of medical and health services in the low level administrative units is the main factor of affecting the spatial difference of medical and health services level.(2)Based on the county administrative "division",from the perspective of the accessibility of medical service,this paper analyzed the spatial equity of health service under the hybrid and grading treatment system.Based on the assumption of the same level hospitals having the same level and scale,the accessibility of two kinds of medical system indicates that the health service accessibility level in the west areas is relatively high,and that in the east areas take second place,and that in the central areas is the lowest.The weighted average number of the provinces beds,the accessibility of two kinds of medical system indicates that the beds in the east area is relatively high,and that in the west areas take second place,and that in the central areas is the lowest.Under the two conditions,the results of hierarchical treatment system indicate the referral rate is high,and the health service accessibility is lower.The difference results of health service accessibility shows that,under both of two kinds of treatment system,the spatial fairness of medical and health service is gradually reduced from east to west in China.The difference results of health service accessibility of the hierarchical treatment system shows that,where there is lower referral rate,the higher the spatial equity of health service.(3)Regional medical mode is mainly on the redistribution of medical resources.This medical mode can eliminate the "segmentation" caused by administrative district,and reduce the accessibility differences of regional health services,and thus improve the spatial fairness of medical service.The empirical study shows that,under the hybrid and grading treatment system,where there is the higher level of cross administrative region under the cross-regional medical mode,there is the smaller scale of villages and towns without effective medical and health services,and the higher spatial fairness of medical and health services.Under the two kinds of medical system,the cross-regional medical population mainly concentrated in the area of the east of the Hu-Huanyong line.Under the hierarchical treatment system,where there is the higher referral rate,there is the larger the population benefit,and the more increase fair space of medical and health services.