| Objective: On the basis of the descriptive and statistical analysis of the distributions of medical and health service institutions in Hebei Province,this study is to explore the development law of the demand of medical service in Hebei province,to expose the problems of medical and health services and explore the causes.Hebei province “thirteen five” medical service development plan proposal will be put forward for the government to develop “thirteen five” plan to provide reference based on the demand of socio-economic development and medical and health services during the next five years.Methods:1 Literature review.The literatures,induction learning,and synthesis of regional health planning methods at home and abroad were collected using CNKI,VIP database and Wanfang database,which was the guidance of this study.Collect policy guidelines,the national "thirteen five" plan preparation work requirements,health care reform policy,understanding of regional health planning policy environment.Advice on planning is provided while a comprehensive understanding of resource allocation is made.2 Data collation and analysis.TheThe status quo of the medical and health service institutions in Hebei Province and the cities were analyzed using descriptive statistics.That including medical and health institutions,the status of health human resources,the status of ward beds,medical facilities,health funds and residents'.Some policy recommendations will be put forward after collating,describing and anaylsing the data as well as identifying the problem.3 Expert advice.Some experts who are from provincial health administration,hospital management and health economics were invited to discuss this study for the best survey design,and to explore the main problems existing in Hebei Province.4 Fairness statistical analysis.The basic principle of Lorenz curve [1] is to have different parts of the proportion of health resources from small to large arranged,respectively,as the vertical axis;the corresponding percentage of the cumulative as the horizontal axis,connecting the points for the Los Lenz curve.The closer the curve is to the fair line(45 degrees diagonal),the closer the allocation of health resources is to fairness,whereas the less fairness is.The Gini coefficient equals the ratio of absolute fairness to the area enclosed by the Lorenz curve to the area of the right triangle under the absolute fair line,which [2-4] ranges from 0 to 1.The closer to 0 means that the resource distribution is fairer.The closer to 1,the more concentrated the resource is.0.2 to 0.3 represent the average,0.3 to 0.4 represent the basic reasonable,0.4 to 0.5 that the gap is large,0.5 disparity,0.6 or more is a high degree of unfair risk.0.4 is regarded as a "warning line" for international guideline.All data were analyzed by SPSS13.0 and Excel2007.Results:1 Hebei Province consists of 11 prefecture-level cities,with 188,800 square kilometers totally and 7383.75 million resident population.49.33% of the population was from urban,and 50.67% was from rural areas.The ratio of male to female was 1.03.The olds aged 65 and more(677.09 million)accounted for 9.17% of the total population,children under the age of 14(131,430 million)accounted for 17.80%;2 In 2014,the GDP of Hebei Province reached 2,942,150 million yuan,the per capita GDP was 39,984 yuan,the per capita disposable income of urban residents was 24,141.34,the rural residents was 10,186.14;3 There were 78,906 medical and health institutions,including 1341 hospitals,894 general hospitals,and 75,624 primary health care institutions in Hebei province.The primary health care institutions consisted of 1960 health-centers,1169 community health service centers,1667 professional public health institutions.The number of general hospitals in our province was up to 894,while the number of Chinese medicine hospital and specialist hospitals was relatively small.From the proportion of medical institutions,primary health care institutions,the most medical institutions,accounted for 94.6%,followed by public health institutions,while hospitals,the least medical institutions,only accounted for 0.2%.4 There were 322,909 ward beds totally in Hebei Province,including 236,889 in hospitals,73,108 in primary health care institutions,and 11,907 in professional public health institutions.The number of beds in each region are shown in Table 5,most beds were concentrated in Shijiazhuang,while,the number of beds in Handan,Baoding,Qinhuangdao and Hengshui medical institutions are relatively small.There were 157725 physicians in Hebei Province totally.Most were in Shijiazhuang(49,496),while only 7352 physicians were in Zhangjiakou which had the least physicians.The thousands of practitioners were relatively high in Shijiazhuang and Qinhuangdao,more details are in Table 6,the number of nurses is most in Shijiazhuang(22773);5 The number of medical and health resources in Hebei Province,such as the number of beds,practicing physicians and registered nurses,were significantly correlated with the population.According to the equation,the number of beds,practicing physicians and registered nurses would be predicted based on the predictive population over the next five years;6 The Gini coefficients of the number of ward beds,practicing physicians and nurses in medical and health institutions were 0.1462,0.1132 and 0.1346,respectively,when the population was allocated according to the resident population in Hebei Province.This suggests the medical resources were distributed equally to some extend.Conclusions:The distribution of medical and health resources in Hebei is relatively reasonable,the resources of medical and health resources are not optimized,the distribution of medical and health resources is relatively balanced,the fairness is better than that of medical resources.There is a linear association between medical and health resources and the population.Optimize the allocation of health resources to consider changes in population size and population strategies,such as "two-child policy",the trend of population aging.In addition,the allocation of health resources and the development of regional health planning,should also take the socio-economic,financial investment,health and health policy changes and other factors into account to ensure that the regional health planning is scientific,rational and forward-looking. |
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