| Objective: This study takes Jiangsu province as the research object,starting from the current situation of health resource allocation in Jiangsu province,evaluates the fairness and efficiency of health resource allocation in Jiangsu province,grasses the key factors and prominent problems in the process of resource allocation,and puts forward reasonable suggestions for optimizing resource allocation,in order to provide the basis for deepening the medical reform and promoting the healthy development of health services in Jiangsu province.Method: On the basis of making full use of the literature in the database,this study collects and reads widely the domestic and foreign literature needed in this study.Through the published“Jiangsu Province Health and Family Planning Yearbook”,“China Health and Family Planning Statistical Yearbook”,Collect data on the number of medical and health institutions,number of beds,number of practicing(assistant)physicians,number of registered nurses,and fiscal revenue in Jiangsu province from 2012 to 2016,and descriptive analysis the allocation of health resources in Jiangsu province by using Excel.Gini coefficient is applied to grasp the equity of health resource allocation in Jiangsu province from the population and geographical dimensions.The regional decomposition analysis of equity in Jiangsu province is carried out by using the Theil index.Data envelopment analysis(DEA)was used to analysis the utilization of health resources in 13 cities of Jiangsu province in 2016 and the utilization of health resources in Jiangsu province in 1999-2017(data from “Jiangsu Statistical Yearbook”)through MaxDEA 7.6 Basic,to grasp the characteristics of health resource allocation in Jiangsu province.Result:(1)In 2016,hospitals and primary medical and health institutions accounted for 5.22% and 90.61% of the total number of health institutions in Jiangsu province,respectively.However,the number of beds and on-the-job workers in hospitals accounted for 80.39% and 60.82% respectively.The number of beds and on-the-job workers in primary medical and health institutions accounted for 17.50% and 32.53% of the total number of Jiangsu province,respectively.In 2016,the ratio of medical care in Jiangsu province was 1:1.08,and the proportion of medical care in central Jiangsu was the most unbalanced(1:0.98).From 2012 to 2016,the total growth rates of the number of health institutions,beds and health workers in Jiangsu province were 3.48%,33.01% and 25.75%,respectively,among which the total growth rate of professional public health institutions was the highest,reaching 107.24%,and the total growth rate of primary medical and health institutions was the lowest,reaching 0.79%,and the year-on-year growth rate of hospitals is higher than the total number of health institutions.In 2016,the number of beds,medical technicians,practicing(assistant)physicians and registered nurses per thousand population in southern Jiangsu was 5.78,7.23,2.74 and 3.15 respectively,higher than that in northern Jiangsu(index values were 5.53,5.99,2.44 and 2.56 respectively)and higher than that in central Jiangsu(index values were 5.06,5.78,2.41 and 2.36 respectively).From 2012 to 2016,the total growth rates of health technicians,practicing(assistant)doctors and registered nurses per thousand population in Jiangsu province were 29.40%,28.64% and 41.33%,respectively.The total growth rates of the three indicators were higher than those of the whole country.From 2012 to 2016,the total number of patients and the total number of hospital admissions in Jiangsu province increased by 21.92% and 37.43% respectively,and the carrying capacity of medical services was improved.In 2016,among all kinds of health institutions,the utilization rate of bed in primary medical and health institutions was the lowest,only 60.77%.Among hospitals at all levels,the doctors in provincial general hospitals are the most responsible for diagnosis and treatment,followed by doctors in provincial and municipal hospitals.From 2012 to 2016,the growth rate of financial subsidies for medical and health institutions in Jiangsu province was relatively fast(the total growth rate was 79.60%),and the increase of medical expenses for patients was more reasonable.(2)In terms of fairness,Gini coefficient shows that Jiangsu province is fairly fair,and the fairness of population distribution is better than that of geographical distribution.The Gini coefficient of health resources according to population distribution is lower than 0.2,achieving a high degree of equity.The Gini coefficient of beds and health workers according to geographical distribution is 0.2-0.3,which is fairer.Fairness decomposition analysis by using Theil index shows that among the three regions of southern,central and Northern Jiangsu,the equity of northern Jiangsu is the worst.Interregional inequity is the main cause of inequity in health institutions,and intraregional inequity is the main cause of inequity in beds and health workers.(3)In terms of the utilization efficiency of health resources,the horizontal analysis by using data enveloping method shows that Nanjing,Xuzhou,Zhenjiang and Suqian are DEA effective,while Suzhou and Yangzhou are weak DEA effective.The scale returns of Suzhou are decreasing,and the scale benefits of Yangzhou are increasing.The DEA of the other seven prefecture-level cities is relatively ineffective,and the main reason for DEA inefficiency is input redundancy.Longitudinal analysis shows that the overall efficiency of health resource allocation has steadily increased,the momentum of development is good,and the level of health resource allocation has gradually improved.Conclusion: With the steady progress of medical and health reform,the investment level of health resources in Jiangsu province has been continuously improved,and the carrying capacity and quality of medical services have been gradually improved.The fairness of health resources allocation in Jiangsu province is generally good,but there are also some problems such as insufficient investment in health resources in primary health institutions,obvious differences in fairness among regions,and disparities in utilization efficiency of health resources among cities.Therefore,it is necessary to deepen the hierarchical diagnosis and treatment system,strengthen regional health planning,and improve the functions of government departments to integrate resources,optimize management,make the allocation of health resources more equitable and efficient.In the above ways,the people's growing demand for health will be gradually met. |
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