| Purpose:To evaluate the allocation and utilization of health resources of Chinese medicine in Liaoning Province by establishing a space allocation and fairness evaluation system for health resources of Chinese medicine in the provinces and cities of Liaoning Province.Situation;Through the questionnaire survey of Liaoning Province urban and rural residents of Chinese medicine literacy,based on the two studies,analysis of the relationship between the unfairness of Chinese medicine and health resources and urban and rural residents of Chinese medicine literacy,identify problems and put forward countermeasures.To comprehensively evaluate the allocation level of health resources and the quality level of traditional Chinese medicine in liaoning province and provide data basis for relevant policy formulation.Material and method:Materials were sourced from Liaoning Health Statistics Yearbook from 2004 to 2012 in Liaoning Province;2013 data were sourced from relevant data collected by the Chinese Medicine Administration;vector maps of administrative regions of Liaoning Province;latest census from the National Bureau of Statistics Data;through questionnaires,data on quality of Chinese medicine for urban and rural residents in Liaoning Province were obtained.Research method: Constructing a fairness evaluation system for spatial disposition of health resource allocation of TCM in Liaoning province through literature research;Descriptive statistics Trends in the distribution of health resources of TCM in Liaoning province from 2004 to 2012 ArcGis10.1 software analyzes the spatial distribution of various indicators of health resource allocation for TCM in Liaoning Province in 2013;adopts methods such as Lorentz curve and Gini coefficient in economic theory,and analyzes the city of Liaoning Province from the perspective of population and geographical distribution.The degree of fairness in the allocation of Chinese medicine and medical resources to all TCM medical institutions at or above the district level;compares the indices of Liaoning’s TCM medical institutions(including TCM hospitals and integrated Chinese and Western medicine hospitals)and hospitals other than TCM hospitals.Differences and trends of changes from 2003 to 2012;Liaoning Province urban and rural residents of Chinese medicineliteracy using a four-stage random sampling method,a questionnaire survey,through urban and rural residents of the use of Chinese medicine influencing factors.Results: 1.The application of descriptive statistics,Lorenz curve and Gini coefficient,and GIS geographic information system to construct the evaluation system of the spatial disposition of health resources of Chinese medicine in Liaoning province can comprehensively analyze the fairness of spatial allocation of health resources of Chinese medicine in Liaoning province.Through years of analysis of spatial allocation of TCM resources such as institutions,equipment,manpower,capital expenditure,and income,it can be concluded whether the space allocation of TCM resources is fair.The indicators for the evaluation of the fairness of the allocation of Chinese medicine health resources are mainly the degree of difference in response to the Lorenz curve and the Gini coefficient,which can comprehensively analyze the overall degree of differences in the health resources of Chinese medicine and evaluate the fairness of the distribution of health resources in Chinese medicine.Spatial analysis indicators of TCM health resource allocation were visualized using ArcGIS software.The balance of the distribution of health resources in TCM is reflected by geographical factors,and the fairness of each index by service area allocation is reflected.2.The research on the spatial allocation and fairness evaluation of health resources of Chinese medicine in Liaoning Province found that: In 2013,the number of TCM institutions at county,county,and higher level in Liaoning Province was 81.Only the number of institutions in Shenyang and Dalian increased.Other regions were unchanged or merged and streamlined.There is basically no change in rural areas.In terms of population distribution,the number of thousands of organizations in the province is fairly fair in the province,but the level of distribution is low.The analysis of the number of Chinese medicine personnel found that there were no major changes in the number of thousands of Chinese medicine personnel in the province in the past 10 years.The Gini coefficients of the population of thousands of Chinese medicine practitioners and the number of Chinese medicine practitioners per square kilometer in 2013 were 0.430 and 0.724,respectively,which were unfair and extremely unfair.The number of beds in the urban and rural population of 1,000 were both in the state of fairness,with 0.263 and 0.378 respectively.The number of beds compiled by the city in terms of square kilometers was unfair.The total value of medical equipment for thousands of people above ten thousand yuan in the province was between 0.48-2.59 million yuan per 1,000 people in 2004-2013,an increase of nearly 4.4 times in ten years.In 2013,the total value of medical equipment and thousands of people per square kilometer exceeded ten thousand yuan.The Gini coefficients of the total value of medical equipment above RMB 0.456 and 0.742 were respectively unfair and extremely unfair.Thousands of population outpatients in the province were between 69.09-147.73 person-times per thousand people in 2004-2013,an increase of 1.1 times in ten years.The Gini coefficients of annual outpatients and outpatients per km2 in 2013 were 0.438 and 0.748 respectively.,respectively,in an unfair and extremely unfair state.The annual emergency department of thousands of people in the province was between 2.27-8.24 person-times/1000 people in 2004-2013,which increased by 2.6 times in ten years.The Gini coefficients of annual emergency department and annual emergency department volume per square kilometer of thousands of people in 2013 were 0.671 and 0.814 respectively.All are in an extremely unfair state.The annual hospitalization of thousands of people in the province was between 2.37-9.10 per thousand people in 2004-2013,an increase of 2.8 times in ten years.The Gini coefficient of the annual hospitalization of thousands of people in 2013 and the annual hospitalization per square kilometer was 0.385,0.654.,respectively,in a fair and extremely unfair state.The total annual income of thousands of people in the province during the period from 2004 to 2013 was 0.21-6.96 million yuan per 1,000 population,which increased by 32 times in ten years.In 2013,the Gini coefficient of the total annual income of 1,000 people and the annual total income per square kilometer was 0.473.0.759,respectively,are unfair and extremely unfair.The income of Chinese medicine for thousands of people in the province during the period from 2004 to 2013 was 0.18-1.39 million per 1,000 people,which increased by 6.7 times in ten years.In 2013,the Gini coefficient of Chinese medicine income and annual Chinese medicine income per square kilometer was 0.532.0.809,respectively,is unfair and extremely unfair.3.Comparing the index differences between the TCM medical institutions in Liaoning Province(including TCM hospitals and integrated Chinese and Western medicine hospitals)and hospitals other than TCM hospitals: In terms of the number of institutions,TCM hospitals remained at 103-120 for nearly 10 years.Among the 716-837 non-Chinese medicine hospitals,there was a significant gap between the two,and the gap did not change significantly in 10 years.The percentage of Chinese medicine institutions was between 11.6-14.7%.In the past 10 years,the number of health technicians in each institution of TCM hospitals was slightly higher than that of TCM hospitals.In the past 10 years,the average number of beds in each institution was higher than that of Chinese medicine hospitals.During the 6-year period,the average total value of equipment per million yuan per institution of TCM hospitals was significantly higher than that of TCM hospitals,and the difference between the two increased over time.In 10 years,the average annual income of each institution of TCM hospitals is significantly higher than that of TCM hospitals.In 10 years,the average number of doors per year and the number of emergency rooms for non-Chinese medicine hospitals of TCM hospitals are slightly higher than those of Chinese medicine hospitals.In the past 10 years,the average number of hospital admissions per year for TCM hospitals was higher than TCM hospitals.The Spearman correlation analysis of health resource allocation and utilization in TCM hospitals in 2013 showed that the number of institutions,the number of Chinese medicine staff,the number of prepared beds,the total value of medical equipment over 10,000 yuan,and annual outpatient visits,annual emergency visits,annual hospitalizations The total income of the year,annual income of Chinese medicine was significantly related(p < 0.05).4.A sample survey was conducted on the cultural literacy of TCM in urban and rural residents in Liaoning Province.A total of 4 regions were surveyed in Shenyang,Dalian,Huludao and Liaoyang.Among them,urban areas include Shenyang,Dalian and Huludao,and rural areas include Liaoyang.A total of 1681 questionnaires were distributed in 4 districts/counties,and 1653 valid questionnaires were returned.The effective response rate was 98.33%.The basic situation of the study subjects except statistically different gender and age,all other indicators have statistical differences.Residents’ level of cognition of traditional Chinese medicine is generally limited and one-sided.Regarding the impact of Chinese medicine on health care,nearly 40% of residents think that they are mainly affected by positive influences,20% think that they are positive and negative,and only 4% of residentsthink that they are mainly negative and they are more positive.For the development prospects of TCM,54.9% of the residents are optimistic.Only 9.4% of the residents think that they are not optimistic.Compared with TCM practitioners,residents are less optimistic about TCM’s development prospects.Regarding the attitude of modern science and technology inspection techniques,31.2% of residents expressed their recognition that modern scientific methods can help diagnostics and traditional methods become obsolete.18.0% of the residents are reluctant to use modern methods,which is higher than the proportion of medical personnel in traditional Chinese medicine(p < 0.01).The residents who chose Chinese medicine and Western medicine for the initial illness were 8.8% and 55.2%,respectively,and the residents who chose Chinese medicine were far below the Chinese medical staff.The proportion of urban residents who choose TCM is higher than that of rural residents(p < 0.01).The proportion of residents with chronic diseases who choose TCM is higher than those who do not have chronic diseases(p = 0.020).There was no statistical difference between residents with different degrees.Residents who believe that 44.9% of Chinese people believe that Chinese medicine has a certain degree of scientificity,41.4% of residents are interested in Chinese medicine,43.2% of residents believe in Chinese medicine,and 61.0% of residents oppose "abolishing Chinese medicine." Residents,atisfaction rate with Chinese medicine technology strength,service items,drug types,drug quality,cost of diagnosis and treatment,service attitude,insurance linkage,and overall evaluation were 37.7%,36.3%,35.7%,33.3%,29.8%,37.1%,and 29.0,respectively.% and 31.4%.5.From the multi-factor analysis of factors affecting the quality of TCM and TCM resources allocated by urban and rural residents in Liaoning Province: whether there are chronic diseases in the region,whether they believe that TCM is a relevant factor affecting the cost of TCM,urban residents,people with chronic diseases,and It is believed that the TCM value of Chinese medicine is higher than that of rural residents,those who do not suffer from chronic diseases,and those who do not believe in TCM.The OR values are 3.167,3.043 and 1.561.Conclusion: 1.Liaoning province traditional Chinese medicine health resources allocation level is general,allocation development speed and demand development speed are not synchronous,allocationand utilization level is not balanced,urban and rural differences are obvious.2.The allocation level of health resources of traditional Chinese medicine has increased with each passing decade,but the growth rate is not as fast as the utilization level of health resources.3.Compared with non-traditional Chinese medicine hospitals,the allocation and utilization level of health resources of traditional Chinese medicine is relatively low,which requires further strengthening the investment in the allocation of health resources of traditional Chinese medicine institutions.4.Liaoning’s urban and rural residents have a low level of cognition and trust in traditional Chinese medicine.The consumption level of traditional Chinese medicine among urban and rural residents in liaoning province is low and the service satisfaction of traditional Chinese medicine is low.5.Regional health resources allocation level,to the credibility of traditional Chinese medicine,whether to have chronic diseases such as factors affect the level of use of Chinese medicine,Chinese medicine reasonable allocation of health resources,the improvement of urban and rural residents literacy can increase the use of traditional Chinese medicine health resources. |
