1、目的區(qū)域衛(wèi)生規(guī)劃是政府對衛(wèi)生事業(yè)發(fā)展實行宏觀調(diào)控的重要手段,是解決衛(wèi)生資源配置不合理的有效途徑.制定衛(wèi)生資源配置標準更是區(qū)域衛(wèi)生規(guī)劃的關(guān)鍵.區(qū)域衛(wèi)生規(guī)劃的成敗很大程度上取決于衛(wèi)生資源配置標準的編制質(zhì)量.本文旨在對《四川省衛(wèi)生資源配置標準》的編制方法——衛(wèi)生資源密度指數(shù)法——進行深入探討,構(gòu)建配置標準的評估體系,對《四川省衛(wèi)生資源配置標準》進行評估,為下一個5年的區(qū)域衛(wèi)生規(guī)劃衛(wèi)生資源配置標準的制定提供建議.方法本文從遵循衛(wèi)生部提出的衛(wèi)生資

2、源配置標準編制原則——與國民經(jīng)濟發(fā)展相適應(yīng)的原則、公平性原則、效率原則、總量控制原則、結(jié)構(gòu)優(yōu)化原則——出發(fā),構(gòu)建《標準》的評估體系,通過灰色模型、需求法、基尼系數(shù)比較法等方法從以上五個方面對《標準》進行了評估,最后用模糊綜合評估法對其進行了綜合評估.結(jié)果從滿足五大編制原則角度講:《標準》的編制基本符合區(qū)域的總體發(fā)展規(guī)劃,與國民經(jīng)濟發(fā)展水平相適應(yīng);在總量控制方面編制較好;滿足公平性較好;在滿足效率原則方面有待改進;在結(jié)構(gòu)調(diào)整方面有待細化.

3、在具體各類衛(wèi)生資料的配置上,衛(wèi)生人員、衛(wèi)生經(jīng)費等方面的配置需要細化,大型設(shè)備的配置需要探索新的配置方法,突發(fā)性公共衛(wèi)生事件反應(yīng)系統(tǒng)的資源配置有待增加.在《標準》實施的管理影響因素方面,各地領(lǐng)導(dǎo)對區(qū)域衛(wèi)生規(guī)劃比較重視,但重視程度有待提高.衛(wèi)生部門行政調(diào)配資源能力相對不太理想,需要進一步加強.結(jié)論通過本次評估,建議在下一個五年衛(wèi)生資源配置標準的制定中,對四川省目前編制方法——(衛(wèi)生資源密度指數(shù)法)增加醫(yī)療保障覆蓋率、醫(yī)療服務(wù)需求指標、資源使

4、用率做為密度指數(shù)綜合模型的修訂校正系數(shù).配置重點應(yīng)向公共衛(wèi)生、農(nóng)村衛(wèi)生傾斜;城市衛(wèi)生做好初級醫(yī)療衛(wèi)生保健工作的資源保證.增加《標準》實施考核要求.資源配置以常規(guī)資源和突發(fā)應(yīng)急反應(yīng)資源劃分,分類規(guī)劃.關(guān)鍵詞:區(qū)域衛(wèi)生規(guī)劃 衛(wèi)生資源配置 評估 灰色模型 模糊理論 基尼系數(shù)AbstractObjectiveRegional health planning is not only an important method of governanc

5、e on the health development, but also an effective way to resolve the unreasonable situation of health resource allocation. How to establish an suitable allocation standards of health resource is the focus of regional he

6、alth planning. Win or lost is mostly depended on the standards' quality. This article aims at building the evaluation system of the allocation standards,to evaluate the standards and give advice for next 5-year allocatio

7、n standards by discussing the method—— health resource density index model"——which used to establish the standards.MethodsTo follow the 5 principles which are mentioned by the National Health Department for establish sta

8、ndards: to fit in with the local social economic development; to control gross resource and balance of supply and demand; efficiency;equity; to modify the structure of resource allocation, author sets up the evaluation s

9、ystem to evaluate the standards by Grey model ( GM (1, 1 ) ), Demand-based allocation way,Gini coefficient compare and Fuzzy-Model etc.ResultsFor fit with the establish principles, the standards basically accord with reg

10、ional total developing planning and local economic developing level; do well at control gross resource and equity; need to improve at efficiency and modification of the structure of resource allocation. On each kind of r

11、esource, health manpower and funds etc need to be allocated in detail; the allocation way needs to be explored in large equipment; resource allocation of paroxysmal public health affairs needs to be added. On the adminis

12、tration effect factors of carry out standards, the local leaders pay much attention to regional health planning, while the extent of attention needs to be improved and administrational maneuver ability needs to be strong

13、er.ConclusionThrough the evaluation the author gives advice that when make the next 5 years standards, the revise coefficient in the density index model should be amended by adding the cover rate of health insurance, dem

14、and index in health serviceand the use rate of resource. What's more, more resource should be allocated to public health and rural health, while the primary health service resource should be guaranteed in cities. And the

15、 assessment of requirement should be added into the standards. Finally, the resource should be carved up by the common resource and paroxysmal-based resource.Key words: regional health planning; health resource allocatio