| 引用本文：龚超, 杨思秋, 刘春雨, 李刚, 范海明, 赵承梅.天津市家庭医生签约服务资源配置公平性研究[J].中国卫生政策研究,2022,15(12):60-66 |
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| 天津市家庭医生签约服务资源配置公平性研究 |
| 投稿时间：2022-10-10 修订日期：2022-11-22 PDF全文浏览 HTML全文浏览 |
| 龚超1, 杨思秋1, 刘春雨1, 李刚2, 范海明2, 赵承梅3 |
1. 天津市医学科学技术信息研究所(天津市卫生健康发展研究中心) 天津 300050;
2. 天津市卫生健康委员会 天津 300050;
3. 天津市医学高等专科学校 天津 300222 |
| 摘要:目的：基于社会公平视角，从全市—区域—地区的宏观、中观、微观三个层面，探讨家庭医生签约服务人员和机构配置的公平性差异及时空演变趋势。方法：综合运用威尔逊系数、泰尔指数和区位熵的方法对家庭医生签约服务的人员数和机构数量的公平程度进行总体测算和具体分解。结果：签约服务人员公平程度(0.253~0.218)显著优于签约服务机构(0.846~0.935)，且公平程度不断提升，而机构公平差异不断扩大；区域间差异和区域内差异交替影响了签约服务人员的公平差异，区域间差异是造成签约服务机构整体公平差异的主要原因(大于90%)；签约服务人员和机构区位熵大于1的地区主要集中在市内六区部分地区、环城四区和滨海新区。结论：近年来签约服务人员的公平性差异从远郊地区向环城四区和市内六区集中，签约服务机构区域差异主要体现在西部地区公平性较好，而东部地区略差的态势，如市内六区部分地区、环城四区和滨海新区均存在不同程度的“失衡”的问题，容易出现签约服务供求矛盾。应通过加强政府优化签约服务机构规划布局与管理、拓宽签约服务队伍来源、重视签约服务人员培养、创新服务模式等途径，促进家庭医生签约服务资源配置合理化、均衡化。 |
| 关键词:签约服务资源 均衡化 社会公平 天津市 |
| 基金项目:天津市深化医药卫生体制改革研究项目(2022YG09)；天津市卫生健康科技项目(TJWJ2021MS049) |
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| Research on the equalization of family doctor contract service resource allocation in Tianjin City |
| GONG Chao1, YANG Si-qiu1, LIU Chun-yu1, LI Gang2, FAN Hai-ming2, ZHAO Cheng-mei3 |
1. Tianjin Institute of Medical Science and Technology Information(Tianjin Health Development Research Center), Tianjin 300050, China;
2. Tianjin Health Commission, Tianjin 300050, China;
3. Tianjin Medical College, Tianjin 300222, China |
| Abstract:Objective:To explore the fairness differences and spatial-temporal evolution trends of staffing and institution allocation in family doctor contract services from the perspective of social equity and from the macro-level (city)，meso-level (district) and micro-level (region). Methods: The Wilson coefficient, Theil index and location quotient methods were comprehensively used to generally calculate and specifically decompose the degree of fairness based on the number of staff and institutions in family doctor contract services. Results: The degree of fairness of staff in the contract services (0.253~0.218) was significantly better than that of institutions (0.846~0.935), which continues to improve and creates an increasingly larger difference with the degree of fairness of institutions. The inter-and intra-regional differences alternately affected the difference of fairness of staff in the contract services. On the other hand, the inter-regional difference accounted for most (>90%) of the overall equity difference of institutions in the contract services. The regions with location quotient >1 of staff and institutions in contract services were mainly in some parts of the city's six districts, the four districts around the city and Binhai New Area. Conclusion: In recent years, the fairness differences in the staff of contract service converged from the outer suburbs towards the four districts around the city and the six districts in the city, while the fairness differences in the institution obviously manifested a trend of “low in the east high in the west”. For example, parts of the six districts inside city, four districts around the city and Binhai New Area all have varying degrees of “imbalance” problem, which can easily lead to supply and demand contradictions in the contract services. The government is suggested to optimize the planning layout and management of institutions offering the contract services, expand the source of staff teams in the contract services, and pay attention to the continuous training of staff in the contract services and innovation of medical service modes, so as to promote the rationalization and equalization of the allocation of family doctor contract service resources. |
| Key words:Contract service resources Equalization Social justice Tianjin City |
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