通讯作者: 龚超, Gongchaohealth@163.com

DOI：10.12201/bmr.202301.00005

Research on the equalization of family doctor contract service resource allocation from the perspective of social equity- A case study of Tianjin City

• 摘要：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的人力资源和机构居民的公平性差异以及时空演变趋势；方法：综合运用威尔逊系数系数、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（0.2531~0.2183）显著优于签约服务机构（0.8462~0.9354），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，2017年~2019年区域间贡献为63.89%~54.04%，2020年区域间贡献度为51.25%，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>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，签约服务机构公平性差异明显呈现出“西高-东低”的变化趋势，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、重视签约服务人员持续性培养创新医疗服务模式等途径，促进家庭医生签约服务资源配置合理化、均衡化。

  关键词： 关键词： 天津市 签约服务资源 均衡化 社会公平

   

  Abstract: Abstract: Objective: Based on the perspective of social equity, from the macro-level, meso-level and micro-level of city-region-region, to explore the differences and spatial-temporal evolution trends of human resources and institutional residents of family doctor contract service. Methods: The Wilson coefficient, Theil index and location entropy were comprehensively used to calculate and decompose the equity degree of the number of staff and the number of institutions contracted by family doctors. Results: The degree of fairness of contracted service personnel (0.2531-0.2183) was significantly better than that of contracted service institutions (0.8462-0.9354), and the degree of fairness continued to improve, while the difference of institutional fairness continued to expand. The inter-regional difference and intra-regional difference alternately affected the equity difference of contracted service personnel. The contribution between regions was 63.89%-54.04% from 2017 to 2019, and the contribution between regions was 51.25% in 2020. The inter-regional difference was the main reason for the overall equity difference of contracted service organizations (more than 90%). The regions with locational entropy >1 of contracted service personnel and institutions were mainly concentrated in parts of the six districts of the city, the four districts around the city and Binhai New Area. Conclusion: in recent years the contract service personnel the fairness of the differences from the outer suburbs around four and six in the city area to the central, signing service fairness difference obviously presents the low east west high - trends, such as parts of the six areas inside city, around four area and binhai new area suffer from varying degrees of imbalances problem, its easy to have a signed service supply and demand contradiction. It is necessary to strengthen the government to optimize the planning layout and management of contracted service institutions, expand the source of contracted service teams, and pay attention to the continuous training of contracted service personnel to innovate the medical service model to promote the rationalization and equalization of the allocation of contracted service resources of family doctors.

  Key words: Key words: Tianjin Contract Service Resources equalization Social justice

  提交时间：2023-01-12

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• 序号	提交日期	编号	操作
  1	2022-10-10	bmr.202301.00005V1	下载

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