| Objective: As the executor of TCM development,TCM hospitals bear the important mission of TCM development.Its position in the Chinese medicine industry is not only a medical service provider,but also a barometer and touchstone of the development of Chinese medicine.With the development of society and people’s recognition of traditional Chinese medicine,the role of traditional Chinese medicine hospitals is also evolving.Modern TCM hospitals should not only provide high-quality medical services,but also actively expand the field of TCM services to meet the needs of different groups.Therefore,the allocation and adjustment of health resources in TCM hospitals are of great significance to reflect the trends,changes,problems and rise and fall of TCM development.At the same time,as the main place to promote traditional Chinese medicine,TCM hospitals are also one of the key forces to promote the development and inheritance of ethnic medicine culture.Therefore,establishing effective development strategic planning and formulating corresponding policies to ensure the development and expansion of the cause of traditional Chinese medicine will have practical value and important significance for serving the people’s health and the inheritance and promotion of national culture.At present,how to allocate the resources of traditional Chinese medicine in a fair and effective way to meet the needs of national medical services has become a difficult issue of common concern to our government and society.Therefore,in order to further clarify the current situation of the allocation of traditional Chinese medicine health resources in Xinjiang Uygur Autonomous Region(hereinafter referred to as "Xinjiang")after the "13th Five-Year Plan",establish scientific and reasonable standards and systems for the allocation of traditional Chinese medicine health resources,fully analyze the fairness and efficiency of the allocation of traditional Chinese medicine health resources in all prefectures(cities),and finally find out the problems of traditional Chinese medicine in the allocation of health resources in Xinjiang and propose targeted solutions,And predict the total development of Xinjiang’s traditional Chinese medicine health resources in the next five years,so as to provide a theoretical basis for the innovative progress and sustainable development of traditional Chinese medicine in Xinjiang.Methods: This paper will study from qualitative analysis and quantitative analysis.Qualitative analysis: 1.Literature analysis method: through consulting and collecting a large number of Chinese and foreign periodicals,government official websites and academic websites related to the allocation of TCM health resources,and screening and sorting out the collected literature,the research objects,research methods and research conclusions of the literature were counted,providing theoretical support for the writing of this article The leading experts of Xinjiang Traditional Chinese Medicine and the Scientific Research Department of Xinjiang Medical University and other units conducted in-depth exchanges and discussions on the policies and regulations,theoretical knowledge,development process,value significance and existing problems of traditional Chinese medicine;Quantitative analysis: 1.Descriptive analysis method.This paper makes a descriptive analysis of various health resource indicators of traditional Chinese medicine in Xinjiang from 2016 to 2020 by collecting relevant indicators of traditional Chinese medicine at all levels in Xinjiang and establishing a database,Put forward the gap between the development status quo and the allocation standard.3.Equity analysis method is used to evaluate the distribution and development equity of TCM health resources at all levels in Xinjiang by using the equity research methods of Gini coefficient,Lorenz curve,Thiel index and agglomeration degree.4.Efficiency analysis method is used to evaluate the efficiency research methods of data envelopment method,rank sum ratio comprehensive evaluation method,Evaluate the development efficiency of the allocation of TCM health resources at all levels in Xinjiang.5.The development prediction method predicts the total development and change of TCM health resources in Xinjiang from 2021-2025 by using the research methods of grey prediction model and manpower/population ratio method.Results: 1.The allocation of traditional Chinese medicine health resources in Xinjiang: From 2016 to 2020,the indicators of various traditional Chinese medicine health resources in Xinjiang were gradually improved,and the number of institutions,beds,health personnel,medical services,and characteristic indicators all showed different degrees of growth(the average growth rate reached 30%).In terms of regional distribution,more than 70% of the number of TCM health institutions,beds,TCM health personnel,the number of people in and out of hospital,outpatient and inpatient income,and TCM diagnosis and treatment person-time are mainly distributed in North Xinjiang areas such as A,F,and B.In terms of the ratio of population to area,the number of TCM institutions,beds and TCM health personnel per 10000 people and per 10000 square kilometers in the whole Xinjiang showed a continuous growth trend from year to year,with an average growth rate of 10%-20%.In terms of regional distribution,North Xinjiang,such as A and B,has a dominant position in the number of TCM institutions,beds and TCM health personnel per 10000 people,surpassing the level of the whole Xinjiang.In the past five years,the average ratio of medical care in Xinjiang traditional Chinese medicine hospitals was 1:1.25,and the average ratio of bed care was 7:1,which were in line with the national team’s main health resource allocation standards.In terms of the five northwest provinces and the national average level,Xinjiang Uygur Autonomous Region is in the middle and upper reaches of the other four provinces in terms of the number of TCM institutions,the number of beds and the number of TCM health personnel.Shaanxi Province and Gansu Province are relatively high in terms of the allocation of TCM health resources,but there is a certain gap between them and the national average level.2.Gap analysis of the allocation standard of health resources in the whole Xinjiang: the number of TCM beds in the three types of areas in the whole Xinjiang all meet the low value allocation standard,and the number of TCM beds in the two and three types of areas significantly exceeds the low value of the allocation standard(more than 70%),especially the actual value of E,F,L,N,R areas is far more than 80% of the low value of the allocation standard;As for the licensed(assistant)doctors of traditional Chinese medicine,the difference between the actual value of the three regions and the low value of the configuration standard is 30%-40%,and the actual value of eight regions is lower than the low value of the configuration standard,with the largest difference of 41.73% in the J region.The actual value of 6regions is higher than the high value,and the excess of R region is 50.66%;In terms of the number of nurses in TCM hospitals,the difference between the actual value and the allocation standard in the three regions is 30%-97%,especially in M,L,Q and R regions(more than 96%).In general,the number of beds in traditional Chinese medicine in Xinjiang is highly enriched,but the number of licensed(assistant)doctors and registered nurses in traditional Chinese medicine is relatively insufficient.3.Analysis of equity of health resources of traditional Chinese medicine in Xinjiang: on the Gini coefficient of population allocation,only the number of traditional Chinese medicine institutions in Xinjiang(0.38)is at a relatively unfair level according to the total population,while the other four main indicators(0.17-0.24)are reasonably distributed and in a fair state.Compared with the health resources in Xinjiang,the fairness of health resources allocation according to population(0.10-0.24)in Xinjiang is better than that of traditional Chinese medicine,especially in the number of institutions.In terms of the Gini coefficient allocated by area,the allocation of traditional Chinese medicine and health resources in Xinjiang(0.52-0.65)is highly unreasonable and in a relatively unfair state.In comparison with the health resources in Xinjiang,the fairness of the allocation of traditional Chinese medicine health resources according to geographical distribution in Xinjiang is better than that of the health resources(0.59-0.64),but still higher than the warning line,and the overall planning and optimal allocation of traditional Chinese medicine health resources according to geographical area need to be carried out;In terms of the concentration degree of population allocation,the traditional Chinese medicine and health resources allocated by population in northern and eastern Xinjiang are relatively reasonable and in a relatively rich state.In terms of the degree of agglomeration allocated by area,A,P,R and other regions are highly concentrated in various resources of traditional Chinese medicine in Xinjiang according to the geographical area,at a relatively surplus level,while the ratio of K,L,H and other regions is less than 0.5,showing a relatively deficient situation;In terms of the Thar index analysis,the total Thar index of traditional Chinese medicine and health resources in Xinjiang is 0.0067-0.1178,showing a good level of resource allocation and a high degree of rationality.In the difference contribution rate,most of the index differences come from the inter-group,which shows that the difference between the prefectures(cities)is the main reason for the gap in the allocation of traditional Chinese medicine resources in Xinjiang.From the analysis of the three regions,most of the difference contribution rates of indicators mainly come from the northern Xinjiang region,which shows that the difference in the northern Xinjiang region is the root cause of the difference in the distribution of traditional Chinese medicine resources in the three regions.4.Efficiency analysis of traditional Chinese medicine health resources in Xinjiang: In terms of data envelopment analysis,the traditional Chinese medicine health resources of A,J,N,Q and R in 2020 are in strong DEA effectiveness,while other regions are in non-DEA effectiveness.In areas with strong DEA effectiveness,the input and output structure of TCM health resources is reasonable,the relative benefits are optimal,the input elements of TCM health resources are fully utilized,and the output is maximized under the given input combination.For non-DEA effective regions,the reasons may be that the structure of input and output in some regions is not reasonable,the relative benefit is not optimal,the utilization of input factors is not maximized,resulting in the production is not the optimal output state,and there may be problems of insufficient production and input redundancy;In the analysis of the comprehensive evaluation method of rank sum ratio,the year with the highest Probit value for the development of traditional Chinese medicine health resources in Xinjiang from 2016 to 2020 is 2019,and the development effect is at three levels(three levels in total),which shows that the development effect of traditional Chinese medicine health resources in Xinjiang in 2019 is the best;In 2016,it was at the lowest Probit value and the development effect was at 2 levels(3 levels in total),indicating that the development effect of traditional Chinese medicine and health resources in Xinjiang was the lowest in 2016.5.Total development of health resources of traditional Chinese medicine in Xinjiang in 2021-2025: According to the grey prediction model,the five indicators of health resources of traditional Chinese medicine in2021-2025 showed a continuous growth trend.In the next five years,the number of institutions,beds,TCM health personnel,TCM practitioners(assistants)and TCM practitioners will increase by 115,11332,4265,4085 and 262 respectively compared with2020,with an average growth rate of 11.68%,26.19%,37.70%,43.69% and 15.44%respectively,;According to the prediction of manpower/population ratio method,the five indicators of traditional Chinese medicine health resources in 2021-2025 show a steady upward trend.In the next five years,the total population,the number of Chinese medicine health personnel,the number of Chinese medicine practitioners(assistants)and the number of Chinese medicine practitioners have increased by 1758625,2888,4391 and 255 respectively compared with 2021,with an average growth rate of 6.68%,24.18%,42.94% and 14.53% respectively,showing a rapid development trend.Conclusion: During the "13th Five-Year Plan" period,the cause of traditional Chinese medicine in Xinjiang has achieved steady and rapid development under the support of the state and the strong leadership of the local government.In terms of the allocation of traditional Chinese medicine and health resources,the traditional Chinese medicine and health resources in Xinjiang maintained a high growth rate from 2016 to2020,and the resources in northern Xinjiang occupied a dominant position;In terms of allocation standard evaluation,the allocation of beds of traditional Chinese medicine in Xinjiang is at a rich level,but the allocation of licensed(assistant)doctors and registered nurses of traditional Chinese medicine needs to be optimized;In terms of fairness evaluation,the distribution of traditional Chinese medicine and health resources in Xinjiang according to population is more equitable than that according to area,and the difference between the north and the south of Xinjiang is large;In terms of efficiency evaluation,the allocation efficiency of traditional Chinese medicine and health resources in half of Xinjiang is relatively high,but the problems of insufficient output and redundant input coexist;In the prediction of the total amount of TCM health resources,through the grey prediction model and the manpower/population ratio method,the five indicators of TCM health resources in 2021-2025 showed a steady upward trend,with a rapid growth rate.in summary,While the cause of traditional Chinese medicine in Xinjiang is developing rapidly,there are also some problems: 1.The weight of the impact of geographical area and population distribution differences on fairness is different in different regions.2.The difference of national policies and local policies affects the importance of traditional Chinese medicine development in different regions.3.The difference of national culture and the concept of medical treatment has become an important factor in promoting the cause of traditional Chinese medicine in different regions.4.The lack of senior talents of traditional Chinese medicine and the allocation structure need to be optimized.5.Financial investment in traditional Chinese medicine Inadequate,the development of the traditional Chinese medicine industry presents a vicious circle.6.Traditional Chinese medicine hospitals present the status quo of Western-based treatment,supplemented by characteristic treatment.7.The resources of traditional Chinese medicine are lack of protection,and the research of preparations is insufficient.We should carry out the following targeted measures: 1.We should strengthen the comprehensive analysis of geographical and demographic factors in regions with different economic levels.2.We should fully respect the differences in local ethnic culture and medical habits.3.We should pay attention to the introduction and implementation of laws and policies with Chinese characteristics.4.We should strengthen the construction of middle and senior talents,optimize the Chinese medicine education system and configuration structure.5.We should establish special funds for the construction of Chinese medicine,support and protect Chinese medicine enterprises.6.We should standardize the inheritance and innovation of Chinese medicine,Broaden the channels for publicity of traditional Chinese medicine 7.Standardize the collection and planting of traditional Chinese medicine,and strengthen the research and development of traditional Chinese medicine preparations. |
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