| Objective: This paper analyzes the current situation of health resource allocation in 58 concentrated contiguous counties(cities,districts)in Gansu Province in 2017 and the development trend in 2013-2017,and evaluates the fairness of health resource allocation from the two dimensions of population and geography.To study the efficiency of health resource allocation,and to find out the problems and causes of the allocation of health resources in 58 concentrated contiguous counties(cities,districts)in Gansu Province.At the same time,the health resources allocation of 58 concentrated contiguous counties(cities,districts)in Gansu Province will be predicted in 2018-2022,so as to realize the optimal allocation of regional health resources and promote the health care of 58 concentrated contiguous counties(cities,districts)in Gansu Province.Provide scientific reference for coordination and sustainable development.Methods:The descriptive research method is adopted for the research on the status quo and development trend of health resource allocation in 58 concentrated contiguous counties(cities,districts)in Gansu Province;the Lorenz curve and Gini coefficient are used for the fairness of health resource allocation;The study of health resource allocation efficiency uses data envelopment analysis(DEA);the prediction of health resources uses gray model and population ratio method.Results:(1)Status of health resources allocation in 58 concentrated contiguous counties(cities,districts)in Gansu ProvinceIn 2017,58 concentrated poverty-stricken counties(cities,districts)in Gansu Province had 103,564 health technicians,including 27,182 practicing(assistant)physicians,23,796 registered nurses,medical care ratio 1:0.88,and 21,279 medical and health institutions.The number of beds is 78,098,and the number of equipmentabove 10,000 yuan is 33,711.There are 3.66 health technicians per 1,000 population,1.43 practicing(assistant)physicians,and 1.25 registered nurses;1.12 medical institutions per 1,000 population and 4.11 beds.In 2017,the total income of 58 medical and health institutions in concentrated poverty-stricken counties(cities,districts)in Gansu Province was 17.748 billion yuan,of which the total hospital revenue was 13.914 billion yuan,accounting for 78.40%;the total cost of medical and health institutions was 219.93.100 million yuan,of which,the total cost of hospitals is 17.317 billion yuan,accounting for 78.74%.(2)Analysis of development trend of health resources in 58 concentrated contiguous counties(cities,districts)in Gansu ProvinceIn 2013-2017,the health human resources of 58 concentrated contiguous counties(cities,districts)in Gansu Province continued to grow steadily.The average growth rate of health technicians,practicing(assistant)physicians and registered nurses was 5.10%,5.80%,respectively.9.55%;the average growth rate of medical institutions,beds and equipment above 10,000 yuan was 1.99%,6.24%,and 10.65%respectively;the overall income and expenditure level of medical and health institutions showed a steady upward trend,and the average growth rate of total income and total expenses were respectively It is 13.73% and 17.53%.(3)Analysis of the fairness of health resource allocation in 58 concentrated contiguous counties(cities,districts)in Gansu Province.The Lorenz curve study found that the concentration of the Lorenz curve in the health resources allocation population of 58 concentrated contiguous cou nties(cities,districts)in Gansu Province is small,and the practicing(assistant)ph ysician is closest to the absolute average,and the registered nurses are relativel y far away.Absolute average line;the geographically fair Lorenz curve is mor e curved,with the number of beds being farthest from the absolute average,a nd the practicing(assistant)physician being relatively closest to the absolute av erage.The Gini coefficients of each indicator according to population allocation are: 0.1972,0.1672,0.1351,0.2358;the Gini coefficients according to geograp hical arrangement are: 0.6334,0.5608,0.4679,0.5554.(4)Analysis of the allocation efficiency of health resources in 58 concentrated contiguous counties(cities,districts)in Gansu ProvinceAccording to the data envelopment analysis software DEAP 2.1,the comprehensive efficiency,technical efficiency and scale efficiency of health resource allocation in 21 poverty-stricken counties(cities,districts)in 58 concentrated co ntiguous counties(cities,districts)in Gansu Province are available.All of them are 1,and the resource allocation is relatively effective;the efficiency of heal th resource allocation in 14 poverty-stricken counties(cities,districts)is weak and effective for DEA;23 poverty-stricken counties(cities,districts)all show t hat DEA is invalid.In terms of the scale and efficiency of input and output o f health resources,21 poverty-stricken counties(cities,districts)are in a state of constant scale and efficiency,and 31 poverty-stricken counties(cities,district s)are in a state of increasing economies of scale,with 6 poverty-stricken coun ties.(City,district)due to the diminishing scale of economies of scale.In terms of vertical development,the efficiency values of 58 concentrated contiguous counties(cities,districts)in Gansu Province in 2014,2015 and 2017 were all <1,and the efficiency values were all 1 in 2013 and 2016,and the slack was equal to 0,which was relatively effective.Status;in 2014,2015 and 2017,the scale benefit value is <1,and the scale benefit value is increasing.In 2013 and 2016,the scale benefit value is 1,and the scale benefit shows a trend.(5)Prediction of health resources of 58 concentrated contiguous counties(ci ties,districts)in Gansu ProvinceAs of 2022,the predicted number of beds,number of institutions,number of practicing(assistant)physicians,and number of registered nurses in 58 pov erty-stricken counties(cities,districts)in Gansu Province are: gray model(5.14,1.32,1.75,1.71),population ratio method(4.88,1.29,1.57,1.68).The predicted relative errors were(0.75%,1.05%,0.61%,2.33%),respectively(2.72%,0.92%,1.65%,1.52%).Conclusions:(1)The total amount of health resources in 58 poverty-stricken counties(cities,districts)in Gansu Province is insufficient,which is lower than the average level of the province,the whole country and the neighboring provinces.(2)In2013-2017,the health resources of 58 poverty-stricken counties(cities,districts)in Gansu Province showed a steady upward trend,and the registered nurses and beds had the fastest growth rate.The medical care ratio is not coordinated.(3)All types of health resources show that population equity is better than geographical equity.Geographical fairness is poor.(4)The overall allocation efficiency of health resourcesin 58 poverty-stricken counties(cities,districts)in Gansu Province is not reasonable.The main problems affecting and restricting the efficiency of health resource allocation in 58 poverty-stricken counties(cities,districts)in Gansu Province include allocation system,configuration structure and management system.(5)The gray model is more accurate for the number of beds and the assistant(assistant)physician,while the error for the number of institutions and registered nurses is relatively large;and the population ratio method makes up for this,bridging the gray The lack of models.(6)As of 2022,the predicted number of beds,number of institutions,number of practicing(assistant)physicians,and number of registered nurses in 58poverty-stricken counties(cities,districts)in Gansu Province are: gray model(5.14,1.32,1.75),1.71),population ratio method(4.88,1.29,1.57,1.68). |
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