我国卫生资源配置区域差异化程度及空间分布趋势研究(2009—2020年)

目的：探索我国卫生资源配置集聚性的现状以及空间自相关特征等空间分布特征。方法：使用2009—2020年卫生资源数据，运用全局和局部空间自相关Moran''I指数分析我国31个省(自治区、直辖市)卫生机构数、床位数、医生数、医技数和护士数的集聚指数和空间差异化程度。结果：2009—2020年，我国卫生资源集聚指数中绝大部分指标呈下降趋势，集聚指数平均值每年大部分均在1.0以上；除了机构、床位数呈上升趋势外，卫生人力集聚性的全局空间自相关指数大都呈下降状态；局部Moran''s I指数显示我国机构、床位与卫生人力资源集聚性冷热点分布呈东、西差异化不均态势，且机构和床位的需重点关注区域集中在东部省份，卫生人力的需重点关注区域集中在东南、西南省份。结论：2009—2020年我国卫生资源总体集聚呈现空间区域差异化分布趋势，尤其东部和南部省份集聚性相对较低，因此建议总体优化东部资源配置结构、优化调整机构和床位资源存量；做大增量、优化存量、提升西部卫生人力资源质量。

A study on the degree of regional difference and trend of spatial distribution of health resource allocation in mainland of China from 2009 to 2020

Objective: To explore the current status of the agglomeration of health resourcein mainland of China and its spatial distribution characteristics. Methods: Based on the health resource data from 2009 to 2020, global and local spatial autocorrelation Moran''I index was used to analyze the extent of agglomeration and spatial differentiation of the numbers of health institutions, beds, doctors, medical technicians and nurses in 31 provinces of mainland of China. Results: Most of the indicators of nationwide health resource agglomerationshowed a decreasing trend from 2009 to 2020, with the average valuesmostly above 1.0 in each year. Except for the numbers of institutions and beds which showed an increasing trend, most of the global spatial autocorrelation indexes of theagglomeration of health human resource showed a decreasing trend. Moreover, local Moran''s I index showed that the hotspotdistribution in the agglomeration of institutions, beds and health human resources in China is unevenly differentiated between the eastern and western regions., and the areas that need strong attentionregarding institutions and beds are mostly in the eastern provinces, whereas areas that need strong attentionregardinghealth human resources are mostly in the southeastern and southwestern provinces.Conclusions: From 2009 to 2020, the distribution of health resource in mainland of Chinagenerally manifesteda trend of spatial and regional differentiation.Especially, the eastern and southern provinces manifested a lowerlevel of agglomeration. Therefore, it is suggested that the resource allocation structure in eastern China should be optimized by optimizing and adjusting institutional and bed resource inventory; on the other hand, the stock of healthcare human resources in western China should be increased and the quality should be improved.