乡镇卫生资源的现状分析及建议

现有资料显示,我国乡镇卫生资源配置的主要问题是：卫生机构分布不合理造成部分农村居民就医困难;卫生人力资源结构不合理、学历不高影响卫生资源的充分利用;卫生设备不足留不住病人,造成其他卫生资源的浪费;门诊有效需求不足不利于“预防为主”方针的贯彻。针对上述问题,可选取的对策是：严格规范卫生机构的布局;吸引和稳定农村卫生人才;建立帮扶机制,促进设备更新;完善新型农村合作医疗制度。     

对统筹城乡卫生资源有关问题的思考

公平合理配置卫生资源是卫生改革与发展的重要目标之一。统筹城乡卫生资源，要充分考虑各方面的因素，积极稳妥地进行。一要按照职能任务，确立配置标准；二要全面认识问题，承认合理差距；三要把握配置重点，城乡整体发展；四要随着政策完善，逐步缩小差距。     

我国农村卫生资源配置现状及配置标准研究进展

通过分析我国农村卫生资源配置现状和存在的问题以及资源配置标准研究方法在农村资源配置中的应用情况，为进一步研究和完善我国农村卫生资源配置方法提供依据。     

武汉地区公立健康管理资源配置均衡性研究

目的：评价武汉地区公立健康管理资源配置的均衡性,为进一步改善公立健康管理资源配置提供参考。方法采用描述性研究、洛伦茨曲线、基尼系数、泰尔指数,分析2015年武汉市13个区216家公立健康管理机构、729位持证健康管理师数量的配置现状及均衡性。结果健康管理师基于服务人口和地域配置的基尼系数分别为0.467和0.580,泰尔指数为0.384和0.735;公立健康管理机构基于服务人口和地域配置的基尼系数分别为0.175和0.507,泰尔指数为0.051和0.621。城乡间差异是健康管理资源按面积配置不均衡的主要原因,贡献率为54.29%、83.89%;城区、农村各自内部差异是健康管理资源按人口配置不均衡的主要原因,贡献率分别为92.32%、84.62%。结论武汉地区公立健康管理资源配置失衡,呈现城乡、区域间资源分布不均现象,应进一步改善公立健康管理资源配置,尤其要加强农村地区的健康管理资源建设。     

我国农村公共卫生资源配置现状与对策探讨

分析了我国大陆农村公共卫生资源配置存在的经费投入不足、机构设置未达到全覆盖、现有人力资源难以满足需要、资源配置结构性失调等问题,提出制定引导公共卫生资源向农村流动的相关政策、强化政府公共财政投入责任、加强农村公共卫生机构建设、提升公共卫生人力资源素质、调整农村公共卫生资源配置结构、推进乡村一体化管理等对策,为提高农村公共卫生服务水平、推动基本公共卫生服务城乡均等化进程提供参考。     

我国农村基层卫生资源配置现状及对策建议

我国农村卫生资源配置的现状已成为新医改背景下人们关注的热点.文章从农村基层卫生资潭总量、结构、投入和利用效率等方面对中国农村基层卫生资源的现状进行系统分析,针对存在的主要问题,提出建议.     

Allocating resources for health and social care: the significance of rurality

Whilst an allowance is made for sparsity in the allocation of resources for social care services in England, rurality is not a significant factor in health resource allocation. This lack of consistency in resource allocation criteria has become increasingly visible as health and social services departments are required to work in partnership across a range of areas. Differences in funding mechanisms also raise the question of why it is legitimate to make adjustments for rurality in the distribution of some public services, but not for others. Against this background, the present paper considers the case for a rural premium in health resource allocation which, it proposes, can be made on four grounds. First, there is evidence that the current National Health Service (NHS) formula introduces systematic biases in favour of urban areas in the way in which it expresses 'need' for healthcare. Secondly, the way in which the current system compensates for unavoidable variations in the costs of providing services takes insufficient account of the additional costs associated with rural service provision. Thirdly, with a growing emphasis on the need to attain national quality standards, rural primary care trusts and social services departments can no longer tolerate lower levels of services. Finally, a case for a rural premium can be made on the basis of precedent. England is the only country in the UK that does not make a major adjustment for rurality in its NHS formula. The paper concludes that the English NHS resource allocation system has done little to counter marked service deprivation in rural areas. Given evidence that rural local authorities also spend less on social care services and direct provision, this raises serious questions about the extent to which the needs of vulnerable people in English rural areas are being adequately served.     

从卫生信息资源的特征 看城乡的科学合理配置

卫生信息资源的特征是该资源的本质和内在规律的表现,它又是目前解决我国城乡卫生事业发展不协调和广大群众尤其农民“看病难、看病贵“这一民生问题,从制度层面搭建起城乡统一的卫生信息资源合理配置新体制机制的重要根据,因此,很有必要深入分析和正确把握我国卫生信息资源的基本内涵、特征,据此,进而深入探讨我国城乡、地区卫生信息资源科学合理配置的新举措。     

运城市农村卫生资源配置现状及对策研究

目的: 了解运城市农村卫生资源配置现状,为合理规划和配置农村卫生资源提供参考依据.方法: 用普查和抽样调查的方法对县、乡、村各级医疗机构基本情况进行调查,并对部分医务人员、卫生行政人员和村民进行深入访谈.结果: 各级卫生机构功能定位不清,卫生资源配置结构不合理,卫生人力资源素质低,床位资源利用率低,卫生经费投入不足.结论: 健全农村社区卫生服务网络,大力发展适合农村卫生服务的全科医生培养,强化农村卫生服务保障制度.     

基于泰尔指数和集中指数的我国妇幼保健资源配置 公平性评价

摘要:目的　分析评价我国妇幼保健资源分布情况及其公平性。方法　主要利用集中指数、集中曲线和泰尔指数进行测算。结果　妇幼保健机构数、妇幼保健机构床位数、妇幼保健机构卫生技术人员数的集中指数CI分别为:-0.108 0、0.118 8、0.172 4,表明我国妇幼保健资源的配置向经济水平较高的地区倾斜较为明显,地区之间妇幼保健资源配置不公平。泰尔指数显示,我国妇幼保健资源地区间仍存在配置差距。各地区内部配置不公平性较为严重,是影响我国妇幼保健资源配置公平性的主要因素。结论　妇幼保健资源配置不合理,妇幼保健资源中机构数、床位数的公平性优于卫生技术人员数的公平性;妇幼保健资源配置地区间较为公平,优化妇幼保健资源配置应重点关注地区内部的不公平,尤其是东部地区;妇幼保健资源配置城乡差异显著,农村地区优于城市地区。     

北京市2017-2018年卫生资源公平性分析

基于对北京市居民对基本社会医疗保险制度的调查及《北京市统计年鉴》的数据,运用卫生资源分布图、集中指数和卡瓦尼指数等方法从资源总体配置公平性、卫生筹资公平性、卫生资源分布公平性3个方面分析北京市2017年、2018年卫生资源配置的情况。2017年、2018年的集中指数、基尼系数、卡瓦尼指数分别为-0.148、0.244、-0.392及-0.065、0.220、-0.285。并针对性提出统筹城乡基本医保,重视卫生资源的合理配置,保障低收入人群诊疗权益,满足不同人群对医保的需求,增加制度的灵活性,使医保向更公平的方向发展等可操作性政策建议。     

The equality of resource allocation in health care under the National Health Insurance System in Taiwan

An ideal resource allocation in health care should ensure most people to access equal health care services while needed. Not only social welfare economists but also health policy makers concern with rational distribution of health care resources. Taiwan implemented a National Health Insurance (NHI) program in 1995, to reduce financial barriers for all residents with a universal health care system. Horizontal equity, an explicit goal of the NHI system, is to guarantee equal opportunity of access to health care. Accordingly, this study, utilizing cross-sectional data, proposes a multi-criteria decision-making approach with grey incidence analysis to measure horizontal equity of health care resource allocation of the NHI in Taiwan. From the findings of this empirical study, most resources are allocated in North Taiwan resulting in geographical disparity due to unbalanced health care resource allocation. And the large-scale hospitals are mostly congregated only at metropolitan regions; therefore, the access to health care services for patients in rural areas is still limited. Finally, the NHI in Taiwan is a single-payer for all hospitals, in which payment for health care suppliers can be adopted as an efficient strategy to induce the disparity of resource allocation and to redistribute national health care resource.     

加入WTO对我国卫生资源配置结构的影响

入世对我国卫生资源配置结构的影响重大而深远，是既有机遇，也有挑战，为了抓住机遇，应对挑战，必须对我国公立医疗机构管理体制进行改革与创新，对我国城乡，地区，医防等卫生资源配置结构进行战略性调整。     

新医改以来我国卫生人力资源配置公平性研究

目的:研究新医改以来我国各地区以及区域之间、城乡之间卫生人力资源分布变化情况及资源配置的公平性,为深化医疗改革、优化卫生资源配置提供一定参考依据。方法:以集聚度分析方法为主、辅助以基尼系数和泰尔指数,对2010-2018年我国卫生人力资源配置的公平性进行分析。结果:新医改以来,我国总体卫生人力资源配置的公平性有所提高,但是区域之间、城乡之间尚存在较大差距。结论:政府应该因地制宜,优化卫生人力资源配置的公平性与可及性,缩小其地区差距和城乡差距,促进其均衡发展。     

农村卫生资源配置综述

我国卫生资源配置城乡差距较大。从卫生经费、设施、人才和城乡配置等方面阐述了我国目前的基本现状,并就这些问题提出了强化政府责任,适度引入私人资本,建立健全人才引入、管理、培养机制,发挥区域卫生规划的作用和完善农村医疗服务体系等建议。     

Equity in resource allocation in the Irish health service. A policy Delphi study

Resource allocation in the Irish health service, based on historical allocations with incremental increases, is widely believed to be inequitable. Using a three-round policy Delphi survey, which seeks to explore both consensus and disagreement surrounding policy issues, the views of 52 senior health service personnel were sought in order to determine ways to improve equity in resource allocation. Panelists provided several reasons why the current method of resource allocation is inequitable and several suggestions for improving equity. The level of consensus on views was determined by calculating the percentage of ratings in each category based on a series of rating scales. The main suggestion centred around the development and implementation of a needs based resource allocation formula. Panelists reached a high consensus in favour of this but only reached a low consensus as to its feasibility. Potential obstacles identified included methodological difficulties, insufficient resources and resistance from potential losers. These findings highlight concerns about the lack of transparency in the resource allocation process and openness to the development of a more equitable needs based resource allocation model, a move which is becoming more common internationally. Feasibility concerns should not preclude an attempt to begin this process.     

四川省民族地区乡村两级卫生人力资源配置及需求预测研究

目的 了解四川省民族地区乡村两级卫生人力资源配置现状并进行需求预测,为进一步优化民族地区及其他边远落后地区的乡村卫生人力资源配置提供决策依据.方法 运用卫生资源集聚度(HRAD)评价乡村卫生人员配置公平性;使用卫生资源密度指数(HRDI)测算乡村卫生人员按地理和人口分布的需求量和缺乏量.结果 全省民族地区乡镇卫生院专科...     

Management education for undergraduate doctors. A survey of medical schools

Explores the extent to, and ways in which, doctors are prepared for their future role in management through the undergraduate medical curriculum. Surveys the colleges across the UK offering undergraduate medical education using both prospectuses and questionnaires to establish both inclusion of healthcare management/policy in curricula and the subject content offered. Establishes that the majority of colleges offer some teaching of health care management/policy although the areas of study included vary considerably. The emphasis in most institutions appears to be on introducing the structure and organization of the NHS together with decision making in respect of resource allocation often located within a public health programme. This leads to the tentative conclusion that the management education needs of future public health physicians are reasonably well served while those of hospital doctors and general practitioners need further investigation.     

计量经济学模型在我国卫生资源配置中的构建与应用

目的 运用经典计量经济学模型,从宏观上对我国卫生资源的人力、物力、财力三方面进行预测和分析,进一步了解我国卫生资源发展与我国人口、国内生产总值(GDP)发展的直接、间接关系,探索资源配置中的经济结构问题及解决问题的有效途径.方法 利用1987～2007年时间序列数据构建起卫生资源配置与社会经济发展的联立方程模型,进行预测和结构分析.结果 利用经典计量经济学联立方程模型进行预测,其平均相对误差分别为0.0243、0.0195、0.0175,判定系数R~2分别为0.8153、0.9937、0.9943,卫生总费用相对于GDP发展的弹性系数为1.08.结论 我国卫生资源配置的发展特征为:(1)我国卫生机构床位数、卫生技术人员数、卫生总费用与人口、GDP存在显著的正相关性;(2)我国目前卫生资源仍然处在规模递增阶段,并呈现出良性增长趋势;(3)我国卫生资源配置的稳定增长期将继续延伸,人力、物力、财力的稳步增长,将直接关系到卫生产业未来的可持续增长;(4)卫生总费用与POP、GDP的相关系数R~2最大,说明卫生经费的逐年增长是卫生资源良性发展的关键和保障.     

贫困农村卫生资源配置的问题与对策

我国计划配置农村卫生资源的一贯做法和卫生扶贫方式的选择都是单方面增加了卫生供给量,忽视贫困农民支付能力低下和有效需求不是的问题．使贫困农村卫生资源配置在短缺基础上的供求失衡问题难以缓解,影响了资源配置的效率和效益。该文分析了卫生资源配置问题及形成原因,提出了合理选择卫生扶贫方式,解决供求矛盾的对策。