健康中国战略下广州医疗服务水平的地区差异、动态变化及影响因素分析。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Risk Management and Healthcare Policy Pub Date : 2024-11-14 eCollection Date: 2024-01-01 DOI:10.2147/RMHP.S479911
Hanxiang Gong, Tao Zhang, Xi Wang, Baoxin Chen, Baoling Wu, Shufang Zhao
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引用次数: 0

摘要

目的:本研究探讨健康中国战略下广州市医疗服务水平的地区差异、动态演变及影响因素,为提高服务质量、缩小差距提供依据:采用熵权 TOPSIS 法构建评价体系。达古姆基尼系数分析了地区差异,核密度估计评估了服务水平的分布,托比特回归探讨了影响因素。数据来源于《广州统计年鉴》、广州市卫计委报告、2017-2022年政府工作报告等:研究表明,2017-2022年,广州市不同区域医疗服务水平存在显著差异,中心城区服务质量高于偏远和周边地区。熵权法的应用揭示了医疗业务成本、每千人口注册护士数等指标在评价服务质量中的重要性。根据达古姆基尼系数分解法,广州市医疗服务的地区差异是导致整体发展质量不均衡的主要因素。核密度估计表明,医疗服务质量呈双峰分布,表明服务质量存在异质性,低质量服务地区呈上升趋势。Tobit 模型证实,医疗机构药费、床位使用率、医疗人力资源等因素对提高服务质量有积极影响:本研究独特地整合了熵权 TOPSIS 法、达古姆基尼系数分解法和核密度估计法,剖析了广州市医疗服务的地区差异,为健康中国战略下的医疗服务发展提供了新的视角。研究结果为优化资源配置、提升服务质量、引导区域均衡发展提供了创新框架。
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Analysis of Regional Differences, Dynamic Evolution, and Influencing Factors of Medical Service Levels in Guangzhou Under the Health China Strategy.

Purpose: This study explores regional differences, dynamic evolution, and influencing factors of medical service levels in Guangzhou under the Health China Strategy to provide a basis for improving service quality and reducing disparities.

Patients and methods: An evaluation system was constructed using the entropy weight TOPSIS method. The Dagum Gini coefficient analyzed regional differences, Kernel density estimation assessed service levels' distribution, and Tobit regression explored influencing factors. Data were collected from the "Guangzhou Statistical Yearbook", Guangzhou Health Commission reports, and government work reports from 2017 to 2022.

Results: The study shows that from 2017 to 2022, there were significant differences in medical service levels among different regions of Guangzhou, with higher service quality in central urban areas compared to remote and peripheral areas. The application of the entropy weight method revealed the importance of indicators such as medical business costs and the number of registered nurses per thousand population in evaluating service quality. According to the Dagum Gini coefficient decomposition method, regional differences in medical services in Guangzhou are the main factor causing uneven overall development quality. Kernel density estimation indicates a bimodal distribution of medical service quality, suggesting heterogeneity in service quality and an increasing trend in low-quality service areas. The Tobit model confirms that factors such as medical institution drug costs, bed occupancy rate, and medical human resources have a positive impact on improving service quality.

Conclusion: This study uniquely integrates the entropy weight TOPSIS method, Dagum Gini coefficient decomposition, and Kernel density estimation to dissect regional disparities in Guangzhou's medical services, offering a novel perspective on healthcare evolution under the Health China Strategy. The findings provide an innovative framework for optimizing resource allocation and enhancing service quality, guiding balanced development across regions.

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来源期刊
Risk Management and Healthcare Policy
Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.20
自引率
2.90%
发文量
242
审稿时长
16 weeks
期刊介绍: Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.
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