Article(id=1240738484835643396, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408408, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724342400000, receivedDateStr=2024-08-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773744706591, onlineDateStr=2026-03-17, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773744706591, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773744706591, creator=13701087609, updateTime=1773744706591, updator=13701087609, issue=Issue{id=1240738480549065614, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773744705569, creator=13701087609, updateTime=1773744787657, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240738824918192654, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240738824922386959, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1642, endPage=1647, ext={EN=ArticleExt(id=1240738485213130781, articleId=1240738484835643396, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Research on the regional balance and temporal evolution characteristics of rehabilitation department bed resources in Chinese hospitals, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To evaluate the balance of bed allocation in hospital rehabilitation departments across different regions of China, providing policy recommendations for establishing a rehabilitation health service system that aligns with socioeconomic development and public health needs.

Methods

The number of rehabilitation department beds in hospitals across 31 provinces from 2012 to 2021 was selected. The Dagum Gini coefficient, concentration degree, and kernel density estimation methods were employed to measure the balance of bed allocation and analyze its temporal and spatial evolution characteristics.

Results

From 2012 to 2021, the total number of rehabilitation department beds in Chinese hospitals increased by 196 120, with a growth rate of 270%. The concentration matching levels among provinces gradually narrowed, although there remained significant interprovincial allocation disparities within regions. The density estimation curve indicated a polarization phenomenon in the central region. The Dagum Gini coefficient results revealed that the differences in balance primarily stemmed from the contribution rates between regions, with the contribution rate within regions rising annually from 28.84% to 30.06% by 2021.

Conclusion

The balance of rehabilitation department bed resource allocation in Chinese hospitals improved from 2012 to 2021,with significant impacts from both interregional and intraregional allocation disparities on overall balance. Therefore, it is recommended to scientifically plan the number of rehabilitation department beds in hospitals across regions, enhance the regional bed coordination and sharing mechanism through information technology, and optimize resource allocation patterns.Additionally, further coordinated efforts should be made to promote balanced bed distribution through targeted assistance and optimizing total capacity, thereby better meeting the health service needs of the public.

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目的

评价我国各区域医院康复科床位配置的均衡程度,为建立与社会经济发展和人民健康需求更相适应的康复卫生服务体系提供政策建议。

方法

选取2012—2021年我国31个省份的医院康复科床位数量,采用Dagum基尼系数、集聚度、核密度估计等方法,测度我国医院康复科床位配置的均衡性并分析其时空演化特征。

结果

2012—2021年,我国医院康复科床位数共计增加196 120张,增幅达270%。各省份间的集聚度匹配水平逐步缩小,但地区内省际配置差异较大。密度估计曲线显示,中部地区出现多极化现象。Dagum基尼系数结果表明均衡性差异主要来源于区域间的贡献率,且区域内的贡献率的逐年上升,由28.84%上升至2021年的30.06%。

结论

2012—2021年我国医院康复科床位资源配置的均衡性得到改善,区域间和区域内的配置差异对均衡性有显著的影响。因此,建议科学规划各地医院康复科床位数量,借助信息化建设完善区域床位协调共享机制,优化资源配置格局;通过对口帮扶、盘活总量等方式进一步统筹推进床位的均衡化布局,更好地满足人民群众的健康服务需求。

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冯启明,E-mail:
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朱晨婷(2000—),女,硕士在读,研究方向:卫生资源配置

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朱晨婷(2000—),女,硕士在读,研究方向:卫生资源配置

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Analysis on fairness and efficiency of medical resource allocation in pediatrics of Chinese medicine in Henan Province in 2021[J]. Journal of Zhengzhou University(Medical Sciences),2024, 59(1): 103-108.(In Chinese), articleTitle=Analysis on fairness and efficiency of medical resource allocation in pediatrics of Chinese medicine in Henan Province in 2021, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241081873120678444, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, xref=1., ext=[AuthorCompanyExt(id=1241081873129067053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, companyId=1241081873120678444, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Research Center for Health and Health Policy, Guangxi Medical University (Nurturing Unit for Guangxi High-end Think Tanks), Nanning, Guangxi 530021, China), AuthorCompanyExt(id=1241081873137455662, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, companyId=1241081873120678444, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广西医科大学卫生与健康政策研究中心(广西高端智库建设培育单位),广西 南宁 530021)]), AuthorCompany(id=1241081873238118969, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, xref=2., ext=[AuthorCompanyExt(id=1241081873246507578, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, companyId=1241081873238118969, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广西医科大学信息与管理学院,广西 南宁 530021)])], figs=[ArticleFig(id=1241081880469099367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=EN, label=Figure 1, caption=Heat map of the matching level of bed resource agglomeration in rehabilitation departments of hospitals in all provinces (municipalities and autonomous regions), figureFileSmall=xIqnL8qOnlI1aCkK0Mcc7A==, figureFileBig=rQDd+LgTtl5PK4+ZImvQfA==, tableContent=null), ArticleFig(id=1241081880590734193, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=CN, label=图1, caption=全国各省(自治区、直辖市)医院康复科床位资源集聚度匹配水平结果热图, figureFileSmall=xIqnL8qOnlI1aCkK0Mcc7A==, figureFileBig=rQDd+LgTtl5PK4+ZImvQfA==, tableContent=null), ArticleFig(id=1241081880758506360, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=EN, label=Figure 2, caption=Kernel density estimate of bed resource allocation agglomeration in national and regional hospital rehab departments, figureFileSmall=pluWm3c8LDCG6O01AhdlJw==, figureFileBig=2ZlOx7YmXV5u1CNIVviHyw==, tableContent=null), ArticleFig(id=1241081880863363966, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=CN, label=图2, caption=全国及各地区医院康复科床位资源配置集聚度匹配水平的核密度估计图, figureFileSmall=pluWm3c8LDCG6O01AhdlJw==, figureFileBig=2ZlOx7YmXV5u1CNIVviHyw==, tableContent=null), ArticleFig(id=1241081880968221569, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=EN, label=Table 1, caption=

Distribution of resources in rehabilitation hospitals in China

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年份
(年)
全国东部中部西部
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
201272 62634 31522 20016 111
201390 76318 13725.042 6468 33124.327 8635 66325.520 2544 14325.7
2014109 19818 43520.351 0178 37119.633 9746 11121.924 2073 95319.5
2015129 27520 07718.458 8977 88015.441 5727 59822.428 8064 59919.0
2016149 01619 74115.370 01211 11518.944 9243 3528.134 0805 27418.3
2017175 74726 73117.982 09112 07917.350 2885 36411.943 3689 28827.3
2018201 48125 73414.693 95711 86614.559 8109 52218.947 7144 34610.0
2019223 50522 02410.9104 72410 76711.566 5376 72711.252 2444 5309.5
2020246 90723 40210.5113 0718 3478.077 37710 84016.356 4594 2158.1
2021268 74621 8398.9119 7446 6735.985 9088 53111.063 0946 63511.8
), ArticleFig(id=1241081881081467780, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=CN, label=表1, caption=

我国医院康复科床位资源配置现状

, figureFileSmall=null, figureFileBig=null, tableContent=
年份
(年)
全国东部中部西部
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
床位数
(张)
增长床位
数(张)
环比增速
(%)
201272 62634 31522 20016 111
201390 76318 13725.042 6468 33124.327 8635 66325.520 2544 14325.7
2014109 19818 43520.351 0178 37119.633 9746 11121.924 2073 95319.5
2015129 27520 07718.458 8977 88015.441 5727 59822.428 8064 59919.0
2016149 01619 74115.370 01211 11518.944 9243 3528.134 0805 27418.3
2017175 74726 73117.982 09112 07917.350 2885 36411.943 3689 28827.3
2018201 48125 73414.693 95711 86614.559 8109 52218.947 7144 34610.0
2019223 50522 02410.9104 72410 76711.566 5376 72711.252 2444 5309.5
2020246 90723 40210.5113 0718 3478.077 37710 84016.356 4594 2158.1
2021268 74621 8398.9119 7446 6735.985 9088 53111.063 0946 63511.8
), ArticleFig(id=1241081881194713993, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=EN, label=Table 2, caption=

Gini coefficient and its decomposition for the allocation equilibrium of bed resources in the rehabilitation departments of hospitals in China from 2012 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)总体基尼
系数
贡献率(%)区域内基尼系数区域间基尼系数
区域内Gw区域间Gb超变密度Gt东部中部西部东部&中部东部&西部西部&中部
20120.43828.8440.7930.380.4130.2620.4240.3640.5520.476
20130.43829.3040.2030.500.4240.2740.4190.3740.5430.465
20140.44929.4539.1231.420.4340.2800.4400.3850.5490.480
20150.44729.6637.5332.810.4300.2880.4530.3850.5410.478
20160.44329.9539.0031.050.4150.2830.4680.3800.5400.464
20170.44030.7136.2033.100.4160.2960.4650.3880.5280.443
20180.44130.5637.4631.980.4200.2890.4710.3810.5350.448
20190.43830.3438.4631.200.4250.2810.4510.3850.5340.438
20200.43129.9138.3531.740.4250.2690.4310.3760.5300.439
20210.42230.0636.4833.470.4120.2730.4310.3650.5130.437
), ArticleFig(id=1241081881303765907, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484835643396, language=CN, label=表2, caption=

2012—2021年我国医院康复科床位资源配置均衡性的基尼系数及其分解

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)总体基尼
系数
贡献率(%)区域内基尼系数区域间基尼系数
区域内Gw区域间Gb超变密度Gt东部中部西部东部&中部东部&西部西部&中部
20120.43828.8440.7930.380.4130.2620.4240.3640.5520.476
20130.43829.3040.2030.500.4240.2740.4190.3740.5430.465
20140.44929.4539.1231.420.4340.2800.4400.3850.5490.480
20150.44729.6637.5332.810.4300.2880.4530.3850.5410.478
20160.44329.9539.0031.050.4150.2830.4680.3800.5400.464
20170.44030.7136.2033.100.4160.2960.4650.3880.5280.443
20180.44130.5637.4631.980.4200.2890.4710.3810.5350.448
20190.43830.3438.4631.200.4250.2810.4510.3850.5340.438
20200.43129.9138.3531.740.4250.2690.4310.3760.5300.439
20210.42230.0636.4833.470.4120.2730.4310.3650.5130.437
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我国医院康复科床位资源区域均衡性及时空演变特征研究
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朱晨婷 1, 2 , 陈俞君 1, 2 , 黄凌波 1, 2 , 黎娴菁 1, 2 , 康静 1, 2 , 覃娴静 1, 2 , 冯启明 1, 2
现代预防医学 | 卫生政策与管理 2025,52(9): 1642-1647
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现代预防医学 | 卫生政策与管理 2025, 52(9): 1642-1647
我国医院康复科床位资源区域均衡性及时空演变特征研究
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朱晨婷1, 2, 陈俞君1, 2, 黄凌波1, 2, 黎娴菁1, 2, 康静1, 2, 覃娴静1, 2, 冯启明1, 2
作者信息
  • 1.广西医科大学卫生与健康政策研究中心(广西高端智库建设培育单位),广西 南宁 530021
  • 2.广西医科大学信息与管理学院,广西 南宁 530021
  • 朱晨婷(2000—),女,硕士在读,研究方向:卫生资源配置

通讯作者:

冯启明,E-mail:
Research on the regional balance and temporal evolution characteristics of rehabilitation department bed resources in Chinese hospitals
Chen-ting ZHU1, 2, Yu-jun CHEN1, 2, Ling-bo HUANG1, 2, Xian-jing LI1, 2, Jing KANG1, 2, Xian-jing QIN1, 2, Qi-ming FENG1, 2
Affiliations
  • Research Center for Health and Health Policy, Guangxi Medical University (Nurturing Unit for Guangxi High-end Think Tanks), Nanning, Guangxi 530021, China
出版时间: 2025-05-10 doi: 10.20043/j.cnki.MPM.202408408
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目的

评价我国各区域医院康复科床位配置的均衡程度,为建立与社会经济发展和人民健康需求更相适应的康复卫生服务体系提供政策建议。

方法

选取2012—2021年我国31个省份的医院康复科床位数量,采用Dagum基尼系数、集聚度、核密度估计等方法,测度我国医院康复科床位配置的均衡性并分析其时空演化特征。

结果

2012—2021年,我国医院康复科床位数共计增加196 120张,增幅达270%。各省份间的集聚度匹配水平逐步缩小,但地区内省际配置差异较大。密度估计曲线显示,中部地区出现多极化现象。Dagum基尼系数结果表明均衡性差异主要来源于区域间的贡献率,且区域内的贡献率的逐年上升,由28.84%上升至2021年的30.06%。

结论

2012—2021年我国医院康复科床位资源配置的均衡性得到改善,区域间和区域内的配置差异对均衡性有显著的影响。因此,建议科学规划各地医院康复科床位数量,借助信息化建设完善区域床位协调共享机制,优化资源配置格局;通过对口帮扶、盘活总量等方式进一步统筹推进床位的均衡化布局,更好地满足人民群众的健康服务需求。

康复科床位  /  Dagum基尼系数  /  均衡性  /  核密度估计
Objective

To evaluate the balance of bed allocation in hospital rehabilitation departments across different regions of China, providing policy recommendations for establishing a rehabilitation health service system that aligns with socioeconomic development and public health needs.

Methods

The number of rehabilitation department beds in hospitals across 31 provinces from 2012 to 2021 was selected. The Dagum Gini coefficient, concentration degree, and kernel density estimation methods were employed to measure the balance of bed allocation and analyze its temporal and spatial evolution characteristics.

Results

From 2012 to 2021, the total number of rehabilitation department beds in Chinese hospitals increased by 196 120, with a growth rate of 270%. The concentration matching levels among provinces gradually narrowed, although there remained significant interprovincial allocation disparities within regions. The density estimation curve indicated a polarization phenomenon in the central region. The Dagum Gini coefficient results revealed that the differences in balance primarily stemmed from the contribution rates between regions, with the contribution rate within regions rising annually from 28.84% to 30.06% by 2021.

Conclusion

The balance of rehabilitation department bed resource allocation in Chinese hospitals improved from 2012 to 2021,with significant impacts from both interregional and intraregional allocation disparities on overall balance. Therefore, it is recommended to scientifically plan the number of rehabilitation department beds in hospitals across regions, enhance the regional bed coordination and sharing mechanism through information technology, and optimize resource allocation patterns.Additionally, further coordinated efforts should be made to promote balanced bed distribution through targeted assistance and optimizing total capacity, thereby better meeting the health service needs of the public.

Rehabilitation department beds  /  Dagum Gini coefficient  /  Balance  /  Kernel density estimation
朱晨婷, 陈俞君, 黄凌波, 黎娴菁, 康静, 覃娴静, 冯启明. 我国医院康复科床位资源区域均衡性及时空演变特征研究. 现代预防医学, 2025 , 52 (9) : 1642 -1647 . DOI: 10.20043/j.cnki.MPM.202408408
Chen-ting ZHU, Yu-jun CHEN, Ling-bo HUANG, Xian-jing LI, Jing KANG, Xian-jing QIN, Qi-ming FENG. Research on the regional balance and temporal evolution characteristics of rehabilitation department bed resources in Chinese hospitals[J]. Modern Preventive Medicine, 2025 , 52 (9) : 1642 -1647 . DOI: 10.20043/j.cnki.MPM.202408408
康复是健康服务体系的重要部分,也是一项重要的民生工程。2021年,我国发布《关于印发加快推进康复医疗工作发展意见的通知》,提出要加强康复医疗服务体系建设,加快推动康复医疗服务高质量发展。床位是整个康复医疗服务体系的重要资源之一,合理配置能最大化医院康复医疗资源的利用效率与经济社会效益,对促进医疗卫生事业发展具有重大意义[1-3]。在人口老龄化加剧、慢性病致残率上升、残疾人数增加等多种因素的驱动下,我国对康复床位需求进一步扩大,康复医疗服务面临严峻挑战,但也蕴含巨大潜力[4-5]。以往的学者,对医院康复科床位资源配置的研究一般采用泰尔指数、莫兰指数、卫生资源集聚度、卫生资源密度指数等方法,鲜有文献从区域均衡性及时空演变的角度分析医院康复科床位资源配置的动态变化过程[6-9]。基于此,本文综合利用集聚度匹配水平和Dagum基尼系数的方法,对2012—2021年我国医院康复科床位资源的配置的均衡性进行评价,并绘制核密度估计图揭示我国医院康复科床位资源区域均衡性的时空演变特征,以期为建设与经济社会发展水平、人民群众医疗卫生服务需求及积极应对人口老龄化国家战略更适配的医院康复科床位资源配置规划体系提供循证依据。
本研究选取的中国31个省份(不含港澳台)医院康复科床位数来源于2013—2015年的《中国卫生统计年鉴》、2016—2017年《中国卫生和计划生育统计年鉴》以及2018—2022《中国卫生健康统计年鉴》;人口数来源于2013—2021年《中国统计年鉴》;地理面积数来源于民政部公布的行政区划统计表;地区划分根据地理位置和经济发展水平分为东、中、西部地区。
卫生资源集聚度(health resource agglomeration degree,HRAD)主要用于衡量同一地域内不同组间的卫生资源配置的均衡程度[10]。人口集聚度(PAD)指某地区占上一层次区域1%的面积上的人口比重,用来评价人口密度[11]。当HRAD/PAD=1时,该地区的医疗卫生资源处于绝对均衡状态,大于1或小于1时,该地区医疗卫生资源均衡性较差[12]。卫生资源集聚度与人口集聚度之比(HRAD/PAD)集聚度匹配水平可以反映全国31个省(自治区、直辖市)2012—2021年医院康复科床位资源配置的均衡程度。
核密度估计是一种非参数估计方法,旨在估计随机变量的概率密度函数,被广泛运用于地区差异评价及动态演变问题中[13]。核密度曲线的位置、形态及其延展性等特征能够分析我国医院康复科床位资源配置集聚度匹配水平的分布特征和演变规律。
Dagum基尼系数法将总体基尼系数分解为区域内差异、区域间差异和超变密度,可以有效解决研究对象间交叉重叠且无法揭示总体差异来源的问题,弥补了传统基尼系数和泰尔指数的缺陷[14]。本研究使用Dagum基尼系数分析我国医院康复科床位资源配置的区域均衡性的差异及其来源。
本文使用Excel 2021软件计算各省医院康复科床位资源集聚度和人口集聚度;使用Stata软件对各省(自治区、直辖市)医院康复科床位资源的均衡性进行Kernel核密度估计的时空演进分析;应用SPSS 23.0软件进行Dagum基尼系数分解计算区域医院康复科床位资源均衡性区域差异来源。
截至2021年底,我国医院康复科床位总数达到了268 746张,2012—2021年床位总计增加196 120张,增幅达270%,其中东部地区增长数量最多。医院康复科床位增长速度上,全国及各地区床位数量的增速逐年减缓;东、西部地区床位的增长趋势呈“n”字形,2017年达到峰值后速度逐年减缓;中部地区床位增长速度幅度变动较大,呈“W”形波动增长。见表1
集聚度匹配水平结果热图整体呈现“东高西低”格局。其中,较为直观地发现上海、山东、重庆、陕西、河南和甘肃6个省份资源配置由相对匮乏逐步过渡至较为充足,山西、宁夏则与之相反。见图1
2012—2021年我国医院康复科床位资源配置集聚度匹配水平的核密度曲线中心位置整体向集聚度水平值为1缓慢移动;延展性上,曲线左侧明显收敛,右侧的拖尾现象持续存在但呈现出收缩趋势。波峰形态上,由宽峰变为尖峰,主峰和侧峰整体呈现出上升趋势,但是侧峰逐渐消失,双峰向单峰演变,两极分化特征趋于减弱。分地区看,东部地区核密度曲线左侧明显收敛,波峰形态上呈现出宽峰变为尖峰、多峰向单峰逐渐的演变趋势,两极分化特征趋于减弱;中部地区核密度曲线左侧呈现明显的收敛趋势,右侧拖尾呈现出收缩的趋势,存在明显的多峰形态,有明显的多极化分化趋势,但是曲线的峰度上升、变窄;西部地区核密度曲线右侧拖尾现象持续存在,但呈现出收敛趋势,波峰上峰度先降后升,多峰形态不明显,极化特征不强。见图2
我国康复科床位资源配置的总体基尼系数2012年为0.438,2014年增长到0.449后波动下降到2021年的最小值0.422。区域内基尼系数拆解结果显示,2012—2021年,东部地区由0.413波动下降至0.412;中部地区由0.262缓慢上升至0.273;西部地区由0.424波动上升至0.431。区域间基尼系数拆解结果显示,东中部地区的床位配置的均衡性差异变化呈现出先上升后回落的变化轨迹,整体差异逐渐缩小;东西部、中西部地区的配置均衡差异性的变化轨迹均呈现出波动下降的趋势。贡献率上,区域内的贡献率逐步上升,由28.84%上升至2021年的30.06%;区域间的贡献率呈现出下降的趋势,由2012年的40.79%下降至2021年36.48%,下降了4.31%;超变密度的贡献率整体与区域间差异贡献率变相反化,由2012年的30.38%上升至2021年的33.47%。见表2
本研究显示,2012—2021年我国医院康复科床位总量不断增加,虽然东部地区床位数量远远多于中、西部地区,但是在床位环比增速上呈减缓趋势,且逐渐低于中、西部地区,这与全国核密度估计图显示双峰转单峰,右拖尾缓和,两极分化现象得到缓解的现象一致,说明国家正积极统筹,科学合理布局医疗资源,使我国医院康复科床位资源配置的绝对差异得以逐步缩小,区域均衡性得到改善。为实现床位区域均衡性的持续优化,政府应当进一步推动中、西部地区康复医疗三级网络的建设,增加各级医疗机构康复病房数和床位数量,充分考虑到康复治疗具有周期长、床位周转率低的特殊性,结合当地实际,在床位设置上保留足够的弹性空间[15-16]。相关研究认为,仅靠增加床位数并不能满足日益增长的康复需求,重要的是要优化现有的医疗资源配置[17]。需要采取精细化的管理手段,整合医院床位资源,使用公用床位调剂模式,通过月度、季度监控,动态调整康复科床位比例[18-19]
本研究发现,2012—2021年我国各省之间的医院康复科床位资源配置的差距逐步缩小,但是地区内配置仍存在较大的相对差异,中部地区的核密度图出现多极化现象,在2021年出现了明显的多峰形态,说明中部地区的省际床位资源配置差异较大,这可能与中部地区内不同省市之间的经济、医疗水平发展各不相同、资源调配和患者转诊机制尚未成熟以及虹吸效应等原因相关,使得优质的康复资源及患者进一步向发达省份集中。对此,应当积极推进地区之间的信息化建设联通,依托“互联网+医疗”搭建区域内医院康复床位资源的共享平台,通过信息共享打破资源的地区壁垒,统筹区域内床位的使用情况,用配置较充足地区的资源来充实强化资源不充足地区,推动区域间床位资源的共享与互补,减少床位的闲置和资源浪费,将大城市的虹吸效应转变为造血输血功能[20-21]
本研究显示,2012—2021年我国医院康复科床位资源的总体基尼系数由0.438下降至0.416,下降了0.012,空间非均衡程度有了改善。从贡献率上看,2012—2021年地区间贡献率均大于36%,区域的内贡献率约在28%左右,说明影响我国医院康复科床位资源配置均衡性的主要原因是区域间的床位资源配置不公平导致的,与热图整体呈现“东高西低”结果一致。对此,我国医院康复科床位资源配置应当兼顾“人向性”和“地向性”原则,在我国东部及部分中部平原地区,应着重考虑资源相较于人口分布的公平性程度,在地广人稀的西部和部分中部地区,则应着重关注资源相较于地理分布的公平性程度,切实提高资源覆盖率和服务可及性[22]。本研究还发现,区域内的床位资源配置的贡献率由2012年的28.84%增加至2021年的30.06%,说明随着时间的推移,区域内的差异对我国医院康复科床位配置的均衡性将会逐步增强。对此,应当充分“盘活总量”的基础上,通过设立区域医疗中心扩大中心城市优质卫生资源的辐射范围;发挥大型医院的资源和技术优势对经济欠发达地区积极开展对口支援帮扶工作,优化地区内医院康复科床位资源的配置格局,提高医院康复科床位资源的配置和利用水平[23-24]
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2025年第52卷第9期
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doi: 10.20043/j.cnki.MPM.202408408
  • 接收时间:2024-08-23
  • 首发时间:2026-03-17
  • 出版时间:2025-05-10
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  • 收稿日期:2024-08-23
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    1.广西医科大学卫生与健康政策研究中心(广西高端智库建设培育单位),广西 南宁 530021
    2.广西医科大学信息与管理学院,广西 南宁 530021

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