Research And Evaluation Of Medical And Health Services In Xiongan New Area

Objectives To understand the current status and influencing factors of needs and utilization of medical and health services by urban and rural residents in Xiongan New Area,and explore the rationality and effectiveness of medical resource supply,the current study analyze the status of medical and health services in Xiongan New Area based on the perspective of supply and demand.The results can provide basic information and baseline data for improving the formulation of the medical and health service system in Xiongan New Area.Methods A Stratified cluster sampling method was used to investigate the residents' needs and utilization of health services.The one-to-one questionnaire survey was conducted on 800 famlies of Xiongan New Area.The statistical analysis method included chi-square test and unconditional logistic regression,which used to analyze its influencing factors.The census method was used to investigate the status of medical and health resources supply,and a questionnaire survey was conducted on 42 non-profit medical institutions and the emergency offices of the three county health bureaus in Xiongan New Area.The Lorenz curve and Gini coefficient were used to analyze the fairness of the population and geographical distribution of medical resources.The Data Envelopment Analysis method was used to analyze the efficiency of medical resource allocation.The demand method was used to calculate the demand for doctors and sickbeds in Xiongan New Area.The supply-demand ratio were used to evaluate the balance of supply and demand.Results 1 Among the residents,the two-week prevalence of diseases was 9.8%,the prevalence of chronic diseases was 49.5%,the two-week visit rate was 10.2%,and the annual hospitalization rate was 10.5%.2 Gender,age,education and the employment status were the factors that affect the two-weeks prevalence of diseases.Age,the employment status,household income per capita,weight were the influencing factors of the prevalence of chronic diseases.Gender,education,household income per capita,and the employment status were the influencing factors of the two-week visit rate.Age,marriage,the employment status,and distance from medical institutions were the influencing factors of annual hospitalization rate.3 There were no third-level medical institutions or community health service centers in primary medical institutions.There were 16(48.5%)of the 33 township health centers conformed to the formulation standards.4 The medical resources per capita in Xiongan New Area was low level,such as 2.19 sickbeds per 1,000 population,2.50 health professionals per 1,000 population,1.08 doctors per 1,000 population,and 0.85 nurses per 1,000 population.5 The population fairness Gini coefficients of the sickbeds and doctors in Xiongan New Area were 0.110 and 0.033,and the geographical fairness Gini coefficients were 0.140 and 0.013,respectively.Both were highly fair.6 The comprehensive efficiency value of input-output of secondary medical institutions in Rongcheng County and Xiong County was 1,which was relatively effective in achieving DEA,while Anxin County was 0.761.The comprehensive efficiency value of input-output of township health centers in Anxin,Rongcheng,and Xiong County was respectively 0.508,0.906,0.655,which had not reached the best production frontier(BPPF).7 Xiongan New Area needed 1,625 doctors and 5,142 sickbeds.The supplydemand ratios were 0.78 and 0.50,respectively.The supply and demand were extremely unbalanced.Conclusions The residents had a large demand for chronic disease health services in Xiongan New Area,however they underutilized outpatient service utilization.The elderly,overweight or obese people,women,children,low-education,low-income groups were the key populations for Health Services needs and utilization.The efficiency of medical resource allocation in Xiongan New Area was low,and the medical resources of township health centers were insufficient.Xiongan New Area lacked high-quality medical institutions,and the establishment of primary medical service system was weak.The supply of medical resources in Xiongan New Area was generally scarce,and the supply and demand of doctors and sickbeds were extremely unbalanced.The internal structure of health professionals in Xiongan New Area was unreasonable,and the proportion of highlevel personnel is insufficient.Figure 2;Table 31;Reference 123...