Study On The Region Classification Of Medical Center In China

[Purpose] The national regional medical center set up will have significant benefits to implement regional health planning connotation, to ensure the accessibility of health services, as well as to improve health service fairness in the case of existing uneven health resources distribution. It is the embodiment of public welfare in the government-led health services.Thus the scientifically and reasonably region classification is the basic work of medical center construction.This paper is to learn regional classification and selection methods both at China and abroad, besides the influence factors and index considered of region classification of medical center. Based on above, relevant index data of China’s31provinces, autonomous regions, municipalities were analyzed.[Methods](1) Fishbone diagramAccording to the process and principles of region classification of the national medical center, the fishbone diagram method was used to qualitatively analysis of the influence factors of region classification, and to sort them into a coherent and clear graph, in order to better learn and analyze the factors of the classification of the region in the national medical center construction.(2) Descriptive statistical methodsThrough descriptive statistical analysis method and qualitative description, the inherent characteristics of the medical services in China’s31provinces and the basic situations, the classification principles, the influence factors and index considered of region classification of the medical center’s construction were analyzed.(3)Principal component analysisThis study uses the principal component analysis method, from SPSS20.0to filter and merge the selected original indicators, to determine mutually independent and quantitatively less principal component for the classification of the medical area.Instead of a multitude of indicators, principle components were used for the next analysis, providing a measuring tool of follow-up region classification.(4) Clustering analysis On the result of literature research, four indicators were preliminarily selected for the cluster analysis using SPSS20.0.On the basis of the above, classification index system of national regional medical center were set.Then the principal components scores were used to do clustering analysis, in order to evaluating objectively and conducting region classification of the medical centers of the31provinces in China.(5) Geographic information systemIn this paper, geographic information system was used to show directly the classification results by the form of geographic map.[Results]Based on the related research results before, parts of the representative indicators were selected by considering the related factors, in order to evaluating objectively and conducting region classification of medical center construction. The results were as follows:(1) Theoretical analysisThe setting principles and connotation of the national center for health were thorough expounded; The process and principles the region classification of national regional medical center were proposed;Combining documentary analysis, expert consultation and fishbone diagram method, the factors influencing the region classification of national medical center could be divided into six parts including social and economic, geographical environment, population and culture, medical resources, the residents’health status and medical insurances.(2) Preliminary area classification resultsFour indicators respectively about society’s economic status, geographical environment, medical resources and residents’health status were chose to do clustering analysis. It was found that, Shanghai, Beijing, Tianjin are divided into a class alone, which are the first class, second class and third class respectively. Shandong, Guangdong, Liaoning, Fujian, Jiangsu, Zhejiang and Inner Mongolia as the fourth class. Hebei, Hainan, Jilin, Heilongjiang and Shanxi as the fifth class. Shaanxi, Ningxia, Anhui, Henan, Hubei, Hunan, Guangxi, Sichuan and Chongqing as the sixth class. Qinghai, Xinjiang, Yunnan, Gansu, Guizhou, Jiangxi as the seventh class. (3) Regional classified index systemCombining with the mainstream views of scholars at home and abroad, following the principles to established index of comparability, availability, objectivity, representative and comprehensive, the region classification index system of China’s national regional medical center was established, namely six primary indexes and14secondary indicators.(4) Index screening based on principal component analysisIt was found by using principal component analysis method to filter the14indicators that, first three principal components included in the original data information for82.096%>80%, and its characteristic value are greater than1, so the first three principal components were selected for subsequent analysis.(5) Area classification resultsPrincipal component scores of31Provinces were used to conduct the region classification of the national regional medical center through clustering analysis. Shanghai and Beijing for the first category, Tianjin for the second category, Shandong, Guangdong, Jiangsu, Zhejiang for the third class, Shanxi, Heilongjiang, Inner Mongolia, Qinghai, Ningxia, Jilin, Liaoning, Fujian, Hainan is the fourth class, Henan, Sichuan, Anhui, Hubei, Hebei, Hunan is class5, Guangxi, Shanxi, Jiangxi, Yunnan, Guizhou, Chongqing, Xinjiang, Gansu as the sixth class, Tibet for class7.[Conclusion](1)Discussion of adjusting area classificationAfter adjusting the clustering analysis map, geographic adjacent and special circumstances, the area classification were as follows. Shanghai and Beijing for the first category, Tianjin for the second category, Shandong, Guangdong, Jiangsu, Zhejiang, Fujian for the third class, Shanxi, Heilongjiang, Inner Mongolia, Liaoning, Jilin as the fourth class, Henan, Sichuan, Anhui, Hubei, Hebei, Hunan, Jiangxi as the fifth class, Guangxi, Shaanxi, Yunnan, Chongqing, Guizhou, Gansu, Qinghai, Ningxia as the sixth class, Tibet and Xinjiang were seventh and eighth class respectively.(2) Considering put different tactics on different types of regions For disparate areas of the division, different strategies should be considered in the program of the establishment of the national medical centers. For class1to class7in regional classification, the setting tasks of regional medical center are from light to heavy.(3) Discussion of specific construction of regional medical centerSuggestions were put forward, which included that to enhance the government’s macro-control and the regional health planning, to strengthen the leadership, to strive for multi-party cooperation, and to encourage social participation in the construction of the regional medical centers, etc.