Study On The Fairness And Efficiency Of Health Resource Allocation In Township Health Centers In Shandong Province

Objective: The purpose of this study is to analyze the current situation of medical and health resources allocation in township health centers in Shandong Province and to measure their efficiency and fairness,to understand the possible problems in the allocation process,and to provide a theoretical basis and feasible suggestions for further optimization of health resources allocation in township health centers in Shandong Province,with a view to providing support for the construction of healthy villages in Shandong Province and the promotion of sustainable development of the Health China strategy.Methods: This paper mainly applies literature analysis method,Thayer index,and three-stage DEA model to conduct the research.We obtain data about medical and health resources of township health centers in Shandong Province through health and health statistics yearbooks of China and Shandong Province,conduct descriptive analysis of medical and health resources allocation and health service volume of township health centers in Shandong Province,use Lorenz curve and Gini coefficient and Thayer index to analyze the distribution of township health centers in Shandong Province according to resident population and geographical area respectively from 2015 to 2020 The equity of medical and health resources,and the data envelopment analysis of the efficiency of medical and health resources allocation in township health centers in Shandong Province in2020 using the three-stage DEA model..Results: From the allocation of medical and health resources in township health centers in Shandong Province in 2020,the largest number of institutions,beds,licensed(assistant)physicians,registered nurses and pharmacists(nurses)are in Linyi City,with177,15786,5329,4667 and 877 respectively,accounting for 11.7%,16.3%,13.3%,13.3%and 15.4% and 13.8%.From a regional perspective,the three major economic circles,the Lunan economic circle has the most resources in the number of beds,the number of licensed(assistant)physicians,registered nurses and pharmacists(nurses),accounting for41.9%,40.3%,43.5% and 39,2% of the province,respectively,and the provincial capital economic circle has the largest number of institutions,541,accounting for 35.7% of the province.The results of the analysis of the fairness of medical and health resource allocation in township health centers in Shandong province concluded that the fairness of medical and health resource allocation in township health centers in Shandong province by population number is better than that by geographical area;the intra-group differences of the Thiel index are all greater than the contribution of the inter-group differences,and the inequity of medical and health resource allocation is mainly due to the intra-group differences.in 2020,16 local cities in Shandong province adjusted by SFA regression model the mean value of the comprehensive efficiency of township health centers in Shandong province increased from 0.841 to 0.852,which indicates that the efficiency of township health centers in Shandong province is underestimated if the external effects of environmental variables and random noise are not excluded.Conclusion: The equity and efficiency of medical and health resource allocation in township health centers in Shandong Province are in a good situation,but the following problems exist: in terms of health resource allocation status,some municipalities have insufficient medical and health resources and unbalanced resource distribution;inputs are not proportional to outputs;the equity of registered nurses and number of beds is poor relative to other health resources;the equity of the provincial capital economic circle is poor,and intragroup differences are the main factor affecting equity;the operational efficiency of township health centers is underestimated,but the overall efficiency is not high and there are large differences in efficiency between regions,inefficient technological progress hinders the efficiency of township health centers,and external environmental variables have a large impact on the efficiency of township health centers;there is a large gap in the efficiency of health resource allocation between localities in Shandong Province,and the operational efficiency of some localities needs further improvement.Therefore,it is suggested that on the basis of revitalizing the existing resources,the demand of medical market is taken as a prerequisite to give township health centers the autonomy of hiring and the autonomy of distributing the balance of income and expenditure,constantly innovate the introduction of talents,the supervision and incentive mechanism of financial input funds,balance the differences between localities and municipalities,and improve the operational efficiency of township health centers.