| Objective: To understand the situation of the allocation of health resources in public hospitals at county level and above in Guizhou Province from2014 to 2018,to analyze the existing problems,and to provide the basis and reasonable suggestions for formulating the development plan of health and health undertakings in the 14 th Five-Year Plan of Guizhou Province and optimizing the allocation of health resources.Methods: Taking 185 public hospitals at county level and above monitored by health care reform of Guizhou Provincial Health and Health Commission as the research object,the present situation of health resources allocation and health service utilization of public hospitals at county level and above in Guizhou Province are understood by descriptive analysis method,and the fairness of health resources allocation in public hospitals is evaluated by calculating Gini coefficient and Thiel index.Results:(1)Between 2014 and 2018,the total amount of health human resources in public hospitals at the county level and above in Guizhou Province rose steadily,with 120607 health personnel and 104566 health technicians in2018,accounting for 86.70%,and the medical and nursing ratio was 1:1.60.There are1.58 registered nurses per 1,000 population,1.03 medical practitioners per 1,000 population and 2.97 health technicians per 1,000 population.(2)The total number of sanitary beds and sanitary equipment in 2014-2018 showed an upward trend,the actual number of beds increased from 77464 to 101748,the total number of sanitary equipment in 2018 was 86840,and the number of sanitary equipment under 100,000 yuan was the largest,accounting for 76%.(3)Total income and expenditure in2014-2018 showed an increasing trend year by year,with medical income of 41.222 billion yuan in 2018,the main source of hospital income,accounting for 85.34%,followed by financial subsidy income,accounting for 11.36%,medical expenditure,81.03%,management expenditure,15.83%,total income balance of 1.873 billion yuan in 2018,hospital non-liability operation;drug ratio,22.50%,2014-2018,decreasing year by year;outpatient income structure,drug income and examination income decreased,treatment income.(4)In 2018,the total number of patients was51.1031 million,the average daily burden of health technicians,practising(assistant)doctors and registered nurses was 1.64,4.25,3.70,the number of outpatients was42.8816 million,and the number of emergency patients was 6.9076 million.The rate of bed use and the average hospital stay in 2014-2018 were decreasing year by year,the rate of bed use in 2018 was 90.69%,and the average hospital stay was 8.07 days,which was in accordance with the national standard.The daily per capita number of beds for registered nurses decreased slowly,with 1.13 per day for health technicians,2.93 for practising(assistant)physicians and 1.83 for registered nurses.(5)The change of Gini coefficient in public hospitals at county level and above in Guizhou Province in 2014-2018 shows a slow downward trend,and the allocation of health resources is relatively fair in general;the distribution of health resources by population is between 0.20-0.25,the distribution of population is between 0.08-0.30,and the distribution of population is better than that of geographical distribution;the trend of Tier index is basically consistent with Gini coefficient,and the total Tair index is between 0.0165-0.0281 in 2018,and the regional differences are the main factors affecting the allocation of health resources in public hospitals in Guizhou Province.Conclusion:The total amount of all kinds of health resources in public hospitals at the county level and above in Guizhou Province increased year by year from 2014 to 2018,which is still lower than the national average level in the same period,the government's financial subsidy investment is insufficient,and the proportion of medical care allocation is unreasonable.The proportion of drugs decreased,the effect of drug price reform policy appeared initially,and the efficiency of health utilization was improved.The distribution of health resources among different regions of Guizhou Province is large,more health resources are concentrated in areas with better economic conditions,and the equity of health resources allocation is increasing year by year.In general,the distribution of health resources bypopulation is better than geographical distribution,and the regional differences are the main factors affecting the allocation of health resources. |
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