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西藏地区基层卫生资源配置现状及公平性研究

摘要:目的:分析西藏地区基层卫生资源配置现状及公平性,为优化西藏地区基层卫生资源配置提供科学依据 方法:描述性分析2015-2020年西藏地区基层卫生资源配置,并利用基尼系数和集聚度评价2020年西藏地区基层卫生资源配置公平性。结果:西藏基层床位数及各类卫生技术人员数总体呈上升趋势,但仍低于全国水平;西藏基层病床使用率及基层医师工作效率呈下降的趋势;2020年西藏基层卫生资源按人口分布配置的基尼系数均大于0.3,优于按地理配置;西藏西北部地区基层卫生资源集聚度低于东南部,基层卫生资源配置可及性较差。 结论:西藏地区基层卫生人员呈现“低增长、低质量、低效率”趋势,缺少针对地广人稀特点的卫生资源配置标准。建议重视地理因素对基层卫生资源配置公平性的重要影响,打破基层用人机制,改革卫生人力资源管理制度,创新援藏体制机制,并建立基层财政投入新模式。

英文摘要:Objective:To analyze the current situation and fairness of the allocation of primary health resources in Tibet, and to provide a scientific basis for optimizing the allocation of primary health resources in Tibet. Methods:To descriptively analyze the allocation of primary health resources in Tibet from 2015 to 2020, and use Gini coefficient and agglomeration to evaluate the fairness of primary health resource allocation in Tibet in 2020. Results:The number of grass-roots beds in Tibet and the number of various types of health technicians are on the rise in general, but still lower than the national level; the utilization rate of grass-roots hospital beds and the work efficiency of grass-roots doctors in Tibet are on the decline; in 2020, the Gini allocation of grass-roots health resources in Tibet according to population distribution The coefficients are all greater than 0.3, which is better than the allocation by geography; the agglomeration degree of primary health resources in northwestern Tibet is lower than that in southeastern Tibet, and the availability of primary health resource allocation is poor. Conclusion:Primary health workers in Tibet show a trend of "low growth, low quality and low efficiency", and lack the allocation and distribution of human resources and infrastructure in line with the characteristics of vast territory and sparse population. It is suggested to pay attention to the important impact of geographical factors on the fairness of grass-roots health resource allocation, break the grass-roots employment mechanism, establish a new mode of financial investment, innovate the system and mechanism of aid to Tibet, and reform the health human resource management system.

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[V1] 2022-08-12 18:31:09 chinaXiv:202208.00089V1 下载全文
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