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Objective To measure and evaluate the compatibility between the level of outpatient chronic special disease coverage under the basic health insurance and the level of healthcare resource service utilization in Shanxi Province, so as to provide reference for the coordinated development of the level of outpatient chronic special disease coverage under the basic health insurance and the level of healthcare resource service utilization in Shanxi Province.
Methods Taking 11 cities in Shanxi Province as the study object, the fitness between the two was measured using the entropy weight-TOPSIS method and gray correlation analysis.
Results From the perspective of utilization level, the numerical intervals of breadth and depth of healthcare resource service utilization in Shanxi Province were 0.161-0.751 and 0.000-1.000, respectively, with a wide span of the intervals; from the perspective of protection level, the numerical intervals of breadth, width, and sustainability of outpatient chronic and special disease protection of the basic healthcare insurance in Shanxi Province were 0.761-0.994, respectively, 0.518-0.938 and 0.445-1.000; Taiyuan City had a comprehensive score of 0.734, which was the city with the highest degree of suitability.
Conclusion This can be done by consolidating the stability of basic medical and healthcare human resources, enhancing the balance of medical resource allocation, strengthening the synergy between the breadth and depth of healthcare insurance coverage, and reinforcing the linkage between healthcare insurance policies and healthcare resources, so as to improve the level of coverage for outpatient chronic and special illnesses under the basic healthcare insurance scheme in Shanxi Province, as well as the level of utilization of healthcare resources and the degree of appropriateness of the two.
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目的 测算与评估山西省基本医保门诊慢特病保障水平与医疗卫生资源服务利用水平适配度，为山西省基本医保门诊慢特病保障水平与医疗卫生资源服务利用水平的协调发展提供借鉴与参考。
方法 以山西省11个地市为研究对象，利用熵权-TOPSIS法与灰色关联度分析法，测算两者之间的适配度。
结果 从利用水平的角度来看，山西省医疗卫生资源服务利用广度、深度的数值区间分别是0.161~0.751、0.000~1.000，区间跨度较大；从保障水平的角度来看，山西省基本医保门诊慢特病保障广度、宽度、可持续性的数值区间分别是0.761~0.994、0.518~0.938、0.445~1.000；太原市综合得分0.734，为适配度最高的城市。
结论 可通过巩固基层医疗卫生人力资源的稳定性，提升医疗资源配置的均衡性，加强医保保障广度与深度的协同性，强化医保政策与医疗资源的联动性，提高山西省基本医保门诊慢特病保障水平和医疗卫生资源的服务利用水平及二者的适配度。
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Ubc6oEoxaU0NfTaP5Tvrzg==, magXml=1sTl7VoiIuXgIHtOgzHnGg==, pdfUrl=null, pdf=EC1tC67LK+UVBKhfUBA3wQ==, pdfFileSize=948104, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=wa9sN4S7WZ0HBIACVln5gA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=1R/oAiOqnGhHeDUba0XLRg==, mapNumber=null, authorCompany=null, fund=null, authors=
莫玉芳（1999—），女，硕士在读，研究方向：医疗保障与卫生政策管理
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45(1): 2-7. (In Chinese), articleTitle=Strategic purchasing of health insurance to guide the distribution of quality medical resources to subordinate health institutions: Research progress and implications, refAbstract=null)], funds=[Fund(id=1241022956990682096, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, awardId=2023097, language=CN, fundingSource=山西省回国留学人员科研教研资助项目(2023097), fundOrder=null, country=null), Fund(id=1241022957103928314, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, awardId=2023GL0519, language=CN, fundingSource=山西省医疗保障局研究项目(2023GL0519), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241022951584223849, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, xref=null, ext=[AuthorCompanyExt(id=1241022951626166890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, companyId=1241022951584223849, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Management, Shanxi Medical University, Taiyuan, Shanxi 030000, China), AuthorCompanyExt(id=1241022951651332720, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, companyId=1241022951584223849, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西医科大学管理学院，山西 太原 030000)])], figs=[ArticleFig(id=1241022953815593794, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Fig.1, caption=
Measurement results of service utilization level of medical and health resources in Shanxi Province, figureFileSmall=nyKegtJFsYQbmFILYySF5Q==, figureFileBig=wa9sN4S7WZ0HBIACVln5gA==, tableContent=null), ArticleFig(id=1241022953895285577, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=图1, caption=
山西省医疗卫生资源服务利用水平测算结果注：基于2024年版中国行政区划矢量数据绘制，审图号为GS(2024)0650号。
, figureFileSmall=nyKegtJFsYQbmFILYySF5Q==, figureFileBig=wa9sN4S7WZ0HBIACVln5gA==, tableContent=null), ArticleFig(id=1241022954193081182, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Fig.2, caption=
Measurement results of outpatient chronic special disease coverage level of basic medical insurance in Shanxi Province, figureFileSmall=RG/6TsMOUVtMW73phmHRfA==, figureFileBig=HMYY3iLqmlEsyc1mt+dQpA==, tableContent=null), ArticleFig(id=1241022955736585072, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=图2, caption=
山西省基本医保门诊慢特病保障水平测算结果注：基于2024年版中国行政区划矢量数据绘制，审图号为GS(2024)0650号。
, figureFileSmall=RG/6TsMOUVtMW73phmHRfA==, figureFileBig=HMYY3iLqmlEsyc1mt+dQpA==, tableContent=null), ArticleFig(id=1241022955866608501, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Fig.3, caption=
Comprehensive weighted results of the level of outpatient chronic and special disease coverage under the basic health insurance and the level of service utilization of medical and health resources in Shanxi Province, figureFileSmall=WnsIioXMKbpKmy6g8wrUMg==, figureFileBig=P+gBYS8H8PJAepV18laW5g==, tableContent=null), ArticleFig(id=1241022955996631937, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=图3, caption=
山西省基本医保门诊慢特病保障水平与医疗卫生资源服务利用水平综合加权结果注：基于2024年版中国行政区划矢量数据绘制，审图号为GS(2024)0650号。
, figureFileSmall=WnsIioXMKbpKmy6g8wrUMg==, figureFileBig=P+gBYS8H8PJAepV18laW5g==, tableContent=null), ArticleFig(id=1241022956105683853, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Table 1, caption=
Indicator system for the level of outpatient chronic and special disease coverage and the level of utilization of medical and healthcare resources services under the basic medical insurance in Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 一级指标 | 二级指标 | 三级指标 |
|---|
| 医疗卫生资源服务利用水平 | 利用广度 | 机构数量（个） |
| | 医院数量（个） |
| | 基层医疗卫生机构数量（个） |
| | 专业公共卫生机构数量（个） |
| | 其他机构数量（个） |
| 利用深度 | 卫生技术人员数 |
| | 执业（助理）医师数 |
| | 注册护士数 |
| 基本医保门诊慢特病保障水平 | 保障广度 | 参保人数（万人） |
| | 参保率（%） |
| | 登记人数（人） |
| | 保险密度 |
| | 待遇享受人数（人） |
| | 待遇享受人次（次） |
| 保障深度 | 保险深度 |
| | 政策范围内报销比例 |
| | 实际报销比例 |
| 保障可持续性 | 发生费用（万元） |
| | 政策范围内费用（万元） |
| | 统筹基金支付费用（万元） |
), ArticleFig(id=1241022956214735770, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=表1, caption=
山西省基本医保门诊慢特病保障水平与医疗卫生资源服务利用水平指标体系
, figureFileSmall=null, figureFileBig=null, tableContent=
| 一级指标 | 二级指标 | 三级指标 |
|---|
| 医疗卫生资源服务利用水平 | 利用广度 | 机构数量（个） |
| | 医院数量（个） |
| | 基层医疗卫生机构数量（个） |
| | 专业公共卫生机构数量（个） |
| | 其他机构数量（个） |
| 利用深度 | 卫生技术人员数 |
| | 执业（助理）医师数 |
| | 注册护士数 |
| 基本医保门诊慢特病保障水平 | 保障广度 | 参保人数（万人） |
| | 参保率（%） |
| | 登记人数（人） |
| | 保险密度 |
| | 待遇享受人数（人） |
| | 待遇享受人次（次） |
| 保障深度 | 保险深度 |
| | 政策范围内报销比例 |
| | 实际报销比例 |
| 保障可持续性 | 发生费用（万元） |
| | 政策范围内费用（万元） |
| | 统筹基金支付费用（万元） |
), ArticleFig(id=1241022956298621857, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Table 2, caption=
Measurement results of service utilization level of medical and health resources in Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 利用广度 | 利用深度 | 综合加权结果 | 排序 |
|---|
| 太原市 | 0.624 | 1.000 | 0.812 | 1 |
| 运城市 | 0.751 | 0.413 | 0.582 | 2 |
| 临汾市 | 0.626 | 0.341 | 0.484 | 3 |
| 忻州市 | 0.598 | 0.144 | 0.371 | 4 |
| 吕梁市 | 0.515 | 0.158 | 0.337 | 5 |
| 长治市 | 0.351 | 0.262 | 0.307 | 6 |
| 晋中市 | 0.383 | 0.218 | 0.301 | 7 |
| 晋城市 | 0.306 | 0.141 | 0.224 | 8 |
| 大同市 | 0.213 | 0.227 | 0.220 | 9 |
| 朔州市 | 0.280 | 0.000 | 0.140 | 10 |
| 阳泉市 | 0.161 | 0.054 | 0.108 | 11 |
), ArticleFig(id=1241022956390896559, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=表2, caption=
山西省医疗卫生资源服务利用水平测算结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 利用广度 | 利用深度 | 综合加权结果 | 排序 |
|---|
| 太原市 | 0.624 | 1.000 | 0.812 | 1 |
| 运城市 | 0.751 | 0.413 | 0.582 | 2 |
| 临汾市 | 0.626 | 0.341 | 0.484 | 3 |
| 忻州市 | 0.598 | 0.144 | 0.371 | 4 |
| 吕梁市 | 0.515 | 0.158 | 0.337 | 5 |
| 长治市 | 0.351 | 0.262 | 0.307 | 6 |
| 晋中市 | 0.383 | 0.218 | 0.301 | 7 |
| 晋城市 | 0.306 | 0.141 | 0.224 | 8 |
| 大同市 | 0.213 | 0.227 | 0.220 | 9 |
| 朔州市 | 0.280 | 0.000 | 0.140 | 10 |
| 阳泉市 | 0.161 | 0.054 | 0.108 | 11 |
), ArticleFig(id=1241022956483171260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Table 3, caption=
Measurement results of outpatient chronic special disease coverage level of basic medical insurance in Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 保障广度 | 保障深度 | 保障可持续性 | 综合加权结果 | 排名 |
|---|
| 阳泉市 | 0.828 | 0.938 | 0.987 | 0.918 | 1 |
| 临汾市 | 0.921 | 0.589 | 1.000 | 0.837 | 2 |
| 晋城市 | 0.854 | 0.528 | 0.908 | 0.763 | 3 |
| 晋中市 | 0.892 | 0.532 | 0.818 | 0.747 | 4 |
| 大同市 | 0.811 | 0.541 | 0.881 | 0.744 | 5 |
| 长治市 | 0.863 | 0.528 | 0.758 | 0.716 | 6 |
| 运城市 | 0.994 | 0.535 | 0.618 | 0.716 | 7 |
| 朔州市 | 0.886 | 0.518 | 0.628 | 0.677 | 8 |
| 太原市 | 0.859 | 0.524 | 0.585 | 0.656 | 9 |
| 忻州市 | 0.878 | 0.530 | 0.461 | 0.623 | 10 |
| 吕梁市 | 0.761 | 0.532 | 0.445 | 0.579 | 11 |
), ArticleFig(id=1241022956592223177, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=表3, caption=
山西省基本医保门诊慢特病保障水平测算结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 保障广度 | 保障深度 | 保障可持续性 | 综合加权结果 | 排名 |
|---|
| 阳泉市 | 0.828 | 0.938 | 0.987 | 0.918 | 1 |
| 临汾市 | 0.921 | 0.589 | 1.000 | 0.837 | 2 |
| 晋城市 | 0.854 | 0.528 | 0.908 | 0.763 | 3 |
| 晋中市 | 0.892 | 0.532 | 0.818 | 0.747 | 4 |
| 大同市 | 0.811 | 0.541 | 0.881 | 0.744 | 5 |
| 长治市 | 0.863 | 0.528 | 0.758 | 0.716 | 6 |
| 运城市 | 0.994 | 0.535 | 0.618 | 0.716 | 7 |
| 朔州市 | 0.886 | 0.518 | 0.628 | 0.677 | 8 |
| 太原市 | 0.859 | 0.524 | 0.585 | 0.656 | 9 |
| 忻州市 | 0.878 | 0.530 | 0.461 | 0.623 | 10 |
| 吕梁市 | 0.761 | 0.532 | 0.445 | 0.579 | 11 |
), ArticleFig(id=1241022956705469395, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=EN, label=Table 4, caption=
Comprehensive weighted results of the level of outpatient chronic and special disease coverage under the basic health insurance and the level of service utilization of medical and health resources in Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 利用水平 | 保障水平 | 综合加权结果 | 排名 |
|---|
| 太原市 | 0.812 | 0.656 | 0.734 | 1 |
| 临汾市 | 0.484 | 0.918 | 0.701 | 2 |
| 运城市 | 0.582 | 0.744 | 0.663 | 3 |
| 忻州市 | 0.371 | 0.747 | 0.559 | 4 |
| 长治市 | 0.307 | 0.763 | 0.535 | 5 |
| 吕梁市 | 0.337 | 0.716 | 0.526 | 6 |
| 晋中市 | 0.301 | 0.677 | 0.489 | 7 |
| 朔州市 | 0.140 | 0.837 | 0.488 | 8 |
| 大同市 | 0.220 | 0.716 | 0.468 | 9 |
| 晋城市 | 0.224 | 0.623 | 0.423 | 10 |
| 阳泉市 | 0.108 | 0.579 | 0.343 | 11 |
), ArticleFig(id=1241022956806132701, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022948518187474, language=CN, label=表4, caption=
山西省基本医保门诊慢特病保障水平与医疗卫生资源服务利用水平综合加权结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 地区 | 利用水平 | 保障水平 | 综合加权结果 | 排名 |
|---|
| 太原市 | 0.812 | 0.656 | 0.734 | 1 |
| 临汾市 | 0.484 | 0.918 | 0.701 | 2 |
| 运城市 | 0.582 | 0.744 | 0.663 | 3 |
| 忻州市 | 0.371 | 0.747 | 0.559 | 4 |
| 长治市 | 0.307 | 0.763 | 0.535 | 5 |
| 吕梁市 | 0.337 | 0.716 | 0.526 | 6 |
| 晋中市 | 0.301 | 0.677 | 0.489 | 7 |
| 朔州市 | 0.140 | 0.837 | 0.488 | 8 |
| 大同市 | 0.220 | 0.716 | 0.468 | 9 |
| 晋城市 | 0.224 | 0.623 | 0.423 | 10 |
| 阳泉市 | 0.108 | 0.579 | 0.343 | 11 |
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