我国城乡医疗卫生资源配置问题的探讨及对策
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摘要
[目的]分析我国城乡医疗卫生资源配置现状,为进一步解决当前城乡卫生医疗资源的存在的问题提供参考。[方法]通过理论研究、数据对比,对我国城乡的医疗卫生资源情况进行描述性对比分析研究。[结果] 2004-2014年,城市卫生总费用占全国卫生总费用的50%,农村卫生总费用占全国卫生总费用的25%;2009年农村人均卫生总费用为城市人均卫生总费用的25%; 2014年,农村人均卫生费用仅是城市人均费用的50%。2009-2016年,农村每万人医疗机构床位数的增量为城市每万人医疗机构床位数的增量的50%; 2015和2016年,全国医疗机构万元以上医疗设备总台数医院占比分别为77. 15%、77. 66%,乡镇卫生院分别占7. 46%、7. 37%。2012-2016年,城市的卫生人员数基本上都是农村卫生人员数的2～3倍,且在2016年,乡镇卫生院卫生技术人员的学历构成分别是研究生人员比例为0. 1%、大学本科为10%、大专为41. 1%、中专44. 5%;医院的卫生技术人员的学历构成分别是研究生为7%、大学本科为32. 2%、大专为38. 7%、中专为20. 9%。[结论]我国城乡医疗卫生资源配置不均,农村地区存在卫生财力资源投入不足、卫生物力资源匮乏、卫生人力资源缺失等问题。
Objective To analyze current situation of medical and health resources allocation in urban and rural areas of our country so as to provide reference for further solving the existed problems in medical and health resources in urban and rural areas. Methods Descriptively compared,analyzed and studied on the situation of medical and health resources in urban and rural areas of our country by theoretical research and data comparison. Results From 2004 to 2014,total urban health expenditure accounted for 50% of national health expenditure,and total rural health expenditure accounted for 25% of national health expenditure. In 2009,total health expenditure per capita in rural areas accounted for25% of urban health expenditure per capita. In 2014,health expenditure per capita was only 50% of urban health expenditure per capita. From2009 to 2016,increment in number of beds served in medical institutions in each of 10,000 people in rural area was 50% of that in urban area. In 2015 and 2016,total number of medical equipment worth more than RMB 10,000 in medical institutions throughout the country,the hospitals respectively accounted for 77. 5% and 77. 6%,and township medical centers respectively accounted for 7. 46% and 7. 37%. From2012 to 2016,the number of health workers in urban areas was basically 2 to 3 times that in rural areas. In 2016,for the educational background of health technicians in medical center in rural areas,the proportions of personnel with master,bachelor,college degree and secondary vocational education were respectively 0. 1%,10%,41. 1% and 44. 5%. The educational background of health technicians in hospitals in urban areas,the proportions of personnel with master,bachelor,college degree and secondary vocational education were respectively 7%,32. 2%,38. 7% and 20. 9%. Conclusions The allocation of medical and health resources in urban and rural areas of our country is not balanced. In rural areas,there are problems such as inadequate investment in health financial resources,short of health material resources,insufficient health human resources,etc.
Objective To analyze current situation of medical and health resources allocation in urban and rural areas of our country so as to provide reference for further solving the existed problems in medical and health resources in urban and rural areas. Methods Descriptively compared,analyzed and studied on the situation of medical and health resources in urban and rural areas of our country by theoretical research and data comparison. Results From 2004 to 2014,total urban health expenditure accounted for 50% of national health expenditure,and total rural health expenditure accounted for 25% of national health expenditure. In 2009,total health expenditure per capita in rural areas accounted for25% of urban health expenditure per capita. In 2014,health expenditure per capita was only 50% of urban health expenditure per capita. From2009 to 2016,increment in number of beds served in medical institutions in each of 10,000 people in rural area was 50% of that in urban area. In 2015 and 2016,total number of medical equipment worth more than RMB 10,000 in medical institutions throughout the country,the hospitals respectively accounted for 77. 5% and 77. 6%,and township medical centers respectively accounted for 7. 46% and 7. 37%. From2012 to 2016,the number of health workers in urban areas was basically 2 to 3 times that in rural areas. In 2016,for the educational background of health technicians in medical center in rural areas,the proportions of personnel with master,bachelor,college degree and secondary vocational education were respectively 0. 1%,10%,41. 1% and 44. 5%. The educational background of health technicians in hospitals in urban areas,the proportions of personnel with master,bachelor,college degree and secondary vocational education were respectively 7%,32. 2%,38. 7% and 20. 9%. Conclusions The allocation of medical and health resources in urban and rural areas of our country is not balanced. In rural areas,there are problems such as inadequate investment in health financial resources,short of health material resources,insufficient health human resources,etc.
引文
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[2]杜仕林.医疗卫生资源的重新厘定∶基于大资源观的认知视角[J].中国卫生经济,2009,28(5):28-30.
[3]杨展,胡晓,陈饶,等.我国基层医疗卫生资源配置公平性研究[J].中国卫生资源,2017,20(2):106-109,122.
[4]肖峰.我国医疗卫生资源优化配置的经济学分析[J].经济研究导刊,2018,(6):177-178.
[5]马辉.浅议卫生技术人员的概念界定[J].中国医院理,2014,34(8):66-67.
[6]郭赞.我国城乡卫生资源优化配置问题研究[D].长春:东北师范大学,2011.
[7]侯萌.我国农村医疗卫生服务的政府投入研究[D].济南:山东大学,2011.
[8]彭平.我国卫生事业单位人力资源管理的问题与对策[J].人力资源管理,2017,(2):27.
[9]杨森.新医改背景下政府卫生投入存在的问题与对策研究[D].南宁:广西医科大学,2014.
[10]蒋培余,沈志坤,陈婉玉.试析卓越医生计划背景下农村基层全科医学人才的培养[J].黑龙江高教研究,2013,31(4):139-141.