地理研究 ›› 2015, Vol. 34 ›› Issue (11): 2049-2060.doi: 10.11821/dlyj201511004

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中国基础医疗卫生资源供给水平的区域差异

郑文升1,2(), 蒋华雄1,3, 艾红如1,2, 罗静1,2, 王晓芳1,2()   

  1. 1. 华中师范大学地理过程分析与模拟湖北省重点实验室,武汉 430079
    2. 湖北省发展和改革委员会/华中师范大学武汉城市圈研究院,武汉 430079
    3. 北京大学城市规划与设计学院,深圳 518055
  • 收稿日期:2015-06-23 修回日期:2015-08-31 出版日期:2015-11-15 发布日期:2015-11-24
  • 作者简介:

    作者简介:郑文升(1982- ),男,安徽六安人,副教授,主要从事人文—经济地理研究。E-mail: zhengwensheng@mail.ccnu.edu.cn

  • 基金资助:
    国家自然科学基金项目(41371183,41001100);湖北省社会科学基金项目(2014031);中央高校基本科研业务费专项资金项目(CCNU15A02003,CCNU15A05003,CCNU15ZD001)

Analysis of regional inequalities of basic medical resources supply in China

Wensheng ZHENG1,2(), Huaxiong JIANG3, Hongru AI1,2, Jing LUO1,2, Xiaofang WANG1,2()   

  1. 1.Key Laboratory for Geographical Process Analysis & Simulation,Hubei province, Central China Normal University, Wuhan 430079, China
    2. Academy of Wuhan Metropolitan Area, Hubei Development and Reform Commission & Central China Normal University, Wuhan 430079, China
    3. School of Urban Planning and Design, Peking University, Shenzhen 518055, China
  • Received:2015-06-23 Revised:2015-08-31 Online:2015-11-15 Published:2015-11-24

摘要:

基于差异系数、泰尔指数、基尼系数和空间自相关模型,分析1997-2012年中国342个地级单元基础医疗卫生资源供给水平的总体差异与空间格局,结合相关研究文献比较基础医疗卫生资源供给水平空间格局与区域经济空间格局的差异,分析基础医疗卫生资源供给水平区域差异的原因,并提出未来政策应对的方向性建议。研究表明:① 中国基础医疗卫生资源供给水平区域总体差异较大,但近年来呈现波动缩小的趋势;② 中国基础医疗卫生资源供给水平空间关联格局变化较大,主要原因是高值集聚的HH类型和低值集聚的LL类型在空间的分布发生较大变化;③ 区域基础医疗卫生资源供给水平较高地区在中西部地区和东北地区集聚明显,东部地区主要分布在山东半岛与京津地区。相对于区域经济发展差距的扩大,中国基础医疗卫生资源供给水平的差距已经开始缩小,发展水平空间格局也存在显著差别。基础医疗卫生资源供给的区域差异形成的主要原因包括医疗卫生体制改革、国家区域政策热点分布的变化、人口的大规模流动、资源供给管理体制改革的滞后以及医疗卫生服务需求的收入弹性刺激等。

关键词: 基础医疗卫生, 资源供给, 区域差异, 空间分析, 中国

Abstract:

:As an important part of public services, the equal supply of basic medical resources contributes to realizing the equality of public services. Based on the medical statistic data of 342 prefectures in China from 1997-2012 and related studies, the regional inequalities of basic medical resources supply have been examined by coefficient of variation, Theil Index Gini Coefficient and spatial autocorrelation model. This article also explores the causes of these inequalities and recommendations for future policy. Results show that: (1) Despite the regional inequality of basic medical resources supply in China is remarkable, there is still an apparent fluctuation and reduction. (2) The analysis of spatial patterns shows that it is the great changes in spatial distribution of HH (high value agglomeration) type areas and LL (low value agglomeration) type areas, that have mainly caused the regional inequality of basic medical resources supply in China. (3) The areas that have relatively abundant supply in basic medical resources are mainly distributed at central-western and northeastern China, while their parallel areas in eastern China are in the Shandong Peninsula and Beijing-Tianjin region. (4) Compared with the disparity of regional economic development, the inequality of basic medical resources supply in China is diminishing, along with the changes of their spatial patterns. (5) The regional inequality of medical services is regarded as the result of the medical and health system reform, the changes of nation's regional policy, large-scale population migration and unsuited resources supply system, and the special income elasticity of medical service requirement. To make proportional supply of basic medical resources, the departments concerned should establish a national unified social security system and increase the input of basic medical resources on the basis of resident population of each area. Besides, introducing the social and foreign capital into the security system should also be considered.

Key words: Basic medical care, resources supply, regional inequality, spatial analysis, China