Research On The Evaluation And Demand Prediction Of Health Care Resources Allocaion In Guangxi Based On Equalizaion Of Basic Health Care Services

Background: Health care resources allocation is the central task of regional health planning.The rational allocation of health care resources is an important criterion for measuring the development level of health care services in a region.It is a basis for the effective utilization of health care services.In addition,it is conducive to the realization of the goal of every citizen enjoying basic health care services,which was put forward by the new medical reform,and it is also conducive to the full establishment of a basic health care system and an efficient,high-quality health care service system with Chinese characteristics.Guangxi is an economically underdeveloped region.The level of development of health care services is relatively low.Furthermore,the allocation of health care resources lags behind the economically developed eastern provinces.At the same time,it is faced with many challenges such as urbanization,population aging,and changes in disease patterns.At present,Guangxi is in the period of Healthy Guangxi construction,which makes a higher claim for the allocation of health care resources.Objective: Based on the status quo of health care resource allocation in Guangxi,this study analyzed the factors influencing the number of health care resources,and evaluated the equity of health care resources allocation in cities,and predicted the number of health care resources,summarizing the existing problems in the allocation of health care resources,analyzing the causes,proposing to improve the allocation of health care resources,and to provide references for the regional health planning.Methods: In this study,the data related to health care resources,population and geographic area in China,western China and Guangxi was obtained from China Statistical Yearbook 2008-2017,China Statistical Yearbook on Health and Family Planning 2008-2017,Guangxi Statistical Yearbook 2008-2017,Guangxi Health Yearbook 2008-2016,and Guangxi Health and Family Planning Statistical Summary 2017.The electronic map of Guangxi was provided by the Guangxi Bureau of Surveying,Mapping and Geoinformation.Microsoft Excel2013 was employed to input data,calculate Gini coefficient and concentration index,draw Lorenz curve and concentration curve,OpenGeoDa was employed to draw the quartile graphs of health care resources,STATA 12.0 SE was used to conduct multivariate linear regression analysis,R 3.3.3 was used to construct ARIMA model,the gray system theory modeling software(GTM 3.0)was employed to establish the GM(1,1)model.Results:(1)The status quo of health care resources allocation: the number of health care resources in Guangxi showed an upward trend.The number of health institutions rose from 11,737 in 2007 to 29,936 in 2016;the number of beds increased from 104,160 in 2007 to 224,446 in 2016;the number of health personnel increased from 180,921 in 2007 to 390,355 in 2016,and the number of health technicians rose from 147,810 in 2007 to 288,696 in 2016,and thenumber of practicing(assistant)physicians increased from 57,744 in 2007 to100,075 in 2016,and the number of registered nurses increased from 49,959 in2007 to 122,191 in 2016;expenses for health care increased from 4042.44 million in 2007 to 41.69 billion in 2015 with an average annual growth rate of10.96%,8.90%,8.92%,7.72%,6.30%,10.45%,and 33.87%,respectively;(2)Analysis of influencing factors on the number of health care resources: per capita GDP and the number of population have a positive correlation with the number of health care resources(P <0.05);(3)Evaluation on equity of health care resources: From 2007 to 2016,the Gini coefficient by population of health care resources in Guangxi ranged from 0.0907 to 0.4997,and the Gini coefficient by geographical area ranged between 0.2847 and 0.4410,and the concentration index by population ranged from-0.0841 to 0.1748;(4)Health care resources allocation demand forecasting: according to the forecasting results of this study,the number of health institutions,the number of beds,the number of health personnel,the number of health technicians,the number of practicing(assistant)doctors and registered nurses,expenses for health care in Guangxi will reach 38,024,277,906,483,437,351,312,137,506 and 181,119,189.64 billion in 2020,respectively.The number of health institutions,the number of beds,the number of health personnel,the number of health technicians,the number of practicing(assistant)doctors,registered nurses,and expenses for health care per thousand population will reach 0.76,5.52,9.61,6.98,2.73,3.60,3770.20 thousand in 2020,respectively,and the ratio of doctors and nurses will reach 1: 1.32.Conclusions and recommendations: The per capita number of health care resources in Guangxi is lower than the national average,and the equity of the allocation of health care resources is generally improving.The equity bypopulation of health care resources is superior to that by geographic area.Health care resources are in great demand.Health care resources and services are concentrated in the hospitals.The structure of health human resources is unreasonable.In view of the above problems,this research proposed the following policy suggestions: the government should strengthen macroeconomic management to improve equalization of health care resources allocation;further promote the level diagnosis and treatment system and establish an orderly medical pattern;mobilize social forces and explore diversified medical arrangements;strengthen the integration of health care resources to improve the utilization efficiency;develop the economy in economically underdeveloped areas and co-ordinate regional development;strengthen the construction of health informatization,and establish a comprehensive governance system of health care resources;strengthen the management of human care resources to improve the quality of health care services.