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Article(id=1241522767821067009, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202305089, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1683475200000, receivedDateStr=2023-05-08, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931694226, onlineDateStr=2026-03-19, pubDate=1704816000000, pubDateStr=2024-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931694226, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931694226, creator=13701087609, updateTime=1773931694226, updator=13701087609, issue=Issue{id=1241522764012647140, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931693318, creator=13701087609, updateTime=1773931808852, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523248643494379, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523248643494380, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=88, endPage=92, ext={EN=ArticleExt(id=1241522768131445520, articleId=1241522767821067009, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Spatial correlation analysis of primary health resource allocation in Guangxi based on fairness and efficiency, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To measure the fairness and efficiency of primary health resource allocation in Guangxi in 2021, and to explore its spatial autocorrelation pattern.

Methods

The degree of aggregation and data envelopment analysis (DEA) were used to analyze the fairness and efficiency of primary health resource allocation in Guangxi, and the spatial autocorrelation method was used to study the characteristics of spatial distribution of fairness and efficiency.

Results

In 2021, the agglomeration degree of primary health resources in Guangxi cities and prefectures ranged from 0.451 to 2.961, and only 4 of the 14 prefectures and cities were DEA effective. There was a certain spatial aggregation effect in the fairness and efficiency of primary health resources allocation (except scale efficiency).

Conclusion

There is a large gap in the fairness and efficiency of primary health resource allocation in Guangxi, and other indicators except scale efficiency show spatial differentiation distribution to varying degrees. It is suggested that Guangxi strengthen the function of overall planning and promote the reasonable quota and complementary advantages of inter-regional primary health resources based on spatial autocorrelation.

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目的

测度2021年广西基层卫生资源配置的公平性及效率，并在此基础上探讨其空间自相关格局。

方法

运用集聚度和数据包络分析法分析广西基层卫生资源配置公平性与效率，并利用空间自相关方法研究其公平性与效率的空间分布特征。

结果

2021年，广西各地市的基层卫生资源集聚度分布在0.451~2.961之间；14个地市中仅有4市基层卫生资源配置效率为DEA有效；基层卫生资源配置公平性和效率（除规模效率外）均存在一定的空间聚集效应。

结论

广西区域内部的基层卫生资源配置公平性和效率均存在较大差距，除规模效率外的其他指标不同程度地呈现为空间差异化分布。建议广西强化全局规划功能，在考虑空间自相关性的前提下促进地区间基层卫生资源合理配额与优势互补。

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覃娴静，E-mail:
, copyrightStatement=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=eD0FUV+MEHr/O+tFEFx4ZQ==, magXml=eI64+30M42AcaYRoyDGOqw==, pdfUrl=null, pdf=woa2DCyvV9KHNdWDe5xxzg==, pdfFileSize=569377, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=8654rVhHLl0g92YwmbvdBg==, mapNumber=null, authorCompany=null, fund=null, authors=

刘佩芸（1996—），女，硕士在读，研究方向：社会医学与卫生事业管理

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刘佩芸（1996—），女，硕士在读，研究方向：社会医学与卫生事业管理

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刘佩芸（1996—），女，硕士在读，研究方向：社会医学与卫生事业管理

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Equity analysis of primary medical and health resources in Guangxi in 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
地区人口集聚度机构床位人员
集聚度比值集聚度比值集聚度比值
广西1.4411.3490.9361.9391.3461.5861.101
南宁市1.8861.5360.8141.4930.7922.0041.063
柳州市1.0590.9430.8900.7990.7540.9540.901
桂林市0.8431.2611.4960.5790.6870.9331.107
梧州市1.0610.9320.8790.8210.7741.0701.009
北海市2.2151.8650.8421.9510.8812.1110.953
防城港市0.7990.7110.8910.5580.6990.6560.821
钦州市1.4331.4070.9821.8851.3151.4401.005
贵港市1.9362.5681.3271.9110.9871.8240.942
玉林市2.1401.8540.8672.9611.3842.0510.959
百色市0.4660.4991.0730.5991.2870.4851.042
贺州市0.8130.7070.8700.8871.0900.8161.003
河池市0.4820.4961.0290.5061.0500.4510.935
来宾市0.7330.7421.0131.1301.5420.7951.085
崇左市0.5680.4860.8540.5320.9370.5550.977
), ArticleFig(id=1241677621814162398, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=CN, label=表1, caption=

2021年广西基层卫生资源集聚度

, figureFileSmall=null, figureFileBig=null, tableContent=
地区人口集聚度机构床位人员
集聚度比值集聚度比值集聚度比值
广西1.4411.3490.9361.9391.3461.5861.101
南宁市1.8861.5360.8141.4930.7922.0041.063
柳州市1.0590.9430.8900.7990.7540.9540.901
桂林市0.8431.2611.4960.5790.6870.9331.107
梧州市1.0610.9320.8790.8210.7741.0701.009
北海市2.2151.8650.8421.9510.8812.1110.953
防城港市0.7990.7110.8910.5580.6990.6560.821
钦州市1.4331.4070.9821.8851.3151.4401.005
贵港市1.9362.5681.3271.9110.9871.8240.942
玉林市2.1401.8540.8672.9611.3842.0510.959
百色市0.4660.4991.0730.5991.2870.4851.042
贺州市0.8130.7070.8700.8871.0900.8161.003
河池市0.4820.4961.0290.5061.0500.4510.935
来宾市0.7330.7421.0131.1301.5420.7951.085
崇左市0.5680.4860.8540.5320.9370.5550.977
), ArticleFig(id=1241677621948380136, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=EN, label=Table 2, caption=

Analysis of efficiency of allocation of primary medical and health resources in Guangxi in 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
地区综合技术效率纯技术效率规模效率规模报酬相对有效性
广西0.9991.0000.999递减弱有效
南宁市0.8961.0000.896递减弱有效
柳州市0.9650.9890.976递增无效
桂林市1.0001.0001.000不变有效
梧州市0.9200.9860.932递增无效
北海市0.8530.9810.869递增无效
防城港市0.6501.0000.650递增弱有效
钦州市1.0001.0001.000不变有效
贵港市1.0001.0001.000不变有效
玉林市1.0001.0001.000不变有效
百色市0.6420.6670.964递增无效
贺州市0.7790.9140.852递增无效
河池市0.8430.8680.971递增无效
来宾市0.8490.9780.869递增无效
崇左市0.4640.6100.761递增无效
), ArticleFig(id=1241677622095180791, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=CN, label=表2, caption=

2021年广西基层卫生资源配置效率情况

, figureFileSmall=null, figureFileBig=null, tableContent=
地区综合技术效率纯技术效率规模效率规模报酬相对有效性
广西0.9991.0000.999递减弱有效
南宁市0.8961.0000.896递减弱有效
柳州市0.9650.9890.976递增无效
桂林市1.0001.0001.000不变有效
梧州市0.9200.9860.932递增无效
北海市0.8530.9810.869递增无效
防城港市0.6501.0000.650递增弱有效
钦州市1.0001.0001.000不变有效
贵港市1.0001.0001.000不变有效
玉林市1.0001.0001.000不变有效
百色市0.6420.6670.964递增无效
贺州市0.7790.9140.852递增无效
河池市0.8430.8680.971递增无效
来宾市0.8490.9780.869递增无效
崇左市0.4640.6100.761递增无效
), ArticleFig(id=1241677622216814596, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=EN, label=Table 3, caption=

Global spatial autocorrelation analysis results of equity and efficiency of primary health resources in Guangxi in 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
指标Moran IZ值P值
机构集聚度-0.0180.6420.190
床位集聚度-0.121-0.4850.350
人员集聚度-0.0210.5700.204
综合技术效率0.0601.5770.070
纯技术效率0.1542.9560.007
规模效率-0.123-0.5530.323
), ArticleFig(id=1241677622359420940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=CN, label=表3, caption=

2021年广西基层卫生资源公平性与效率的全局空间自相关显著性检验表

, figureFileSmall=null, figureFileBig=null, tableContent=
指标Moran IZ值P值
机构集聚度-0.0180.6420.190
床位集聚度-0.121-0.4850.350
人员集聚度-0.0210.5700.204
综合技术效率0.0601.5770.070
纯技术效率0.1542.9560.007
规模效率-0.123-0.5530.323
), ArticleFig(id=1241677622514610195, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=EN, label=Table 4, caption=

Local spatial autocorrelation analysis results of equity and efficiency of primary health resources in Guangxi in 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
聚集类型机构集聚度床位集聚度人员集聚度综合技术效率纯技术效率规模效率
高-高聚集北海a—北海a梧州a柳州b、桂林b、梧州b—
低-低聚集———百色a崇左b—
低-高聚集梧州b、防城港a梧州a桂林a、梧州b、防城港b———
高-低聚集———玉林a来宾b—
不显著非以上地市非以上地市非以上地市非以上地市非以上地市所有地市
), ArticleFig(id=1241677622661410837, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522767821067009, language=CN, label=表4, caption=

2021年广西基层卫生资源公平性与效率的局部空间自相关显著性检验表

, figureFileSmall=null, figureFileBig=null, tableContent=
聚集类型机构集聚度床位集聚度人员集聚度综合技术效率纯技术效率规模效率
高-高聚集北海a—北海a梧州a柳州b、桂林b、梧州b—
低-低聚集———百色a崇左b—
低-高聚集梧州b、防城港a梧州a桂林a、梧州b、防城港b———
高-低聚集———玉林a来宾b—
不显著非以上地市非以上地市非以上地市非以上地市非以上地市所有地市
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基于公平性与效率的广西基层卫生资源配置空间相关分析
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刘佩芸 1, 2 , 黄同慧 2 , 康静 1, 2 , 黄凌波 1, 2 , 朱晨婷 1, 2 , 冯启明 1, 2 , 覃娴静 1, 2
现代预防医学 | 卫生政策与管理 2024,51(1): 88-92
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现代预防医学 | 卫生政策与管理 2024, 51(1): 88-92
基于公平性与效率的广西基层卫生资源配置空间相关分析
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刘佩芸1, 2, 黄同慧2, 康静1, 2, 黄凌波1, 2, 朱晨婷1, 2, 冯启明1, 2, 覃娴静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

    • 刘佩芸（1996—），女，硕士在读，研究方向：社会医学与卫生事业管理

通讯作者:

覃娴静，E-mail:
Spatial correlation analysis of primary health resource allocation in Guangxi based on fairness and efficiency
Pei-yun LIU1, 2, Tong-hui HUANG2, Jing KANG1, 2, Ling-bo HUANG1, 2, Chen-ting ZHU1, 2, Qi-ming FENG1, 2, Xian-jing QIN1, 2
Affiliations
  • Health and Health Policy Research Center of Guangxi Medical University, Nanning, Guangxi 530021, China
出版时间: 2024-01-10 doi: 10.20043/j.cnki.MPM.202305089
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摘要
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目的

测度2021年广西基层卫生资源配置的公平性及效率，并在此基础上探讨其空间自相关格局。

方法

运用集聚度和数据包络分析法分析广西基层卫生资源配置公平性与效率，并利用空间自相关方法研究其公平性与效率的空间分布特征。

结果

2021年，广西各地市的基层卫生资源集聚度分布在0.451~2.961之间；14个地市中仅有4市基层卫生资源配置效率为DEA有效；基层卫生资源配置公平性和效率（除规模效率外）均存在一定的空间聚集效应。

结论

广西区域内部的基层卫生资源配置公平性和效率均存在较大差距，除规模效率外的其他指标不同程度地呈现为空间差异化分布。建议广西强化全局规划功能，在考虑空间自相关性的前提下促进地区间基层卫生资源合理配额与优势互补。

基层卫生资源  /  公平性  /  效率  /  空间自相关
Objective

To measure the fairness and efficiency of primary health resource allocation in Guangxi in 2021, and to explore its spatial autocorrelation pattern.

Methods

The degree of aggregation and data envelopment analysis (DEA) were used to analyze the fairness and efficiency of primary health resource allocation in Guangxi, and the spatial autocorrelation method was used to study the characteristics of spatial distribution of fairness and efficiency.

Results

In 2021, the agglomeration degree of primary health resources in Guangxi cities and prefectures ranged from 0.451 to 2.961, and only 4 of the 14 prefectures and cities were DEA effective. There was a certain spatial aggregation effect in the fairness and efficiency of primary health resources allocation (except scale efficiency).

Conclusion

There is a large gap in the fairness and efficiency of primary health resource allocation in Guangxi, and other indicators except scale efficiency show spatial differentiation distribution to varying degrees. It is suggested that Guangxi strengthen the function of overall planning and promote the reasonable quota and complementary advantages of inter-regional primary health resources based on spatial autocorrelation.

Primary health resources  /  Equity  /  Efficiency  /  Spatial autocorrelation
刘佩芸, 黄同慧, 康静, 黄凌波, 朱晨婷, 冯启明, 覃娴静. 基于公平性与效率的广西基层卫生资源配置空间相关分析. 现代预防医学, 2024 , 51 (1) : 88 -92 . DOI: 10.20043/j.cnki.MPM.202305089
Pei-yun LIU, Tong-hui HUANG, Jing KANG, Ling-bo HUANG, Chen-ting ZHU, Qi-ming FENG, Xian-jing QIN. Spatial correlation analysis of primary health resource allocation in Guangxi based on fairness and efficiency[J]. Modern Preventive Medicine, 2024 , 51 (1) : 88 -92 . DOI: 10.20043/j.cnki.MPM.202305089
正文
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基层医疗卫生机构是医疗卫生服务体系的重要组成部分，而基层卫生资源作为基层医疗机构发展的基本，其合理配置对于保障广大人民群众的健康权益具有重要意义[1]。经过多年的建设和发展，我国基层卫生事业的发展已然取得显著成就[2]。然而，通过梳理相关文献可知，广西壮族自治区（简称“广西”）仍是我国典型欠发达地区，其基层卫生资源配置存在公平性较高但效率不佳的问题[3-4]。此外，广西基层卫生资源配置公平性和效率的空间自相关特征分别如何？两者是否具有相似性？这些问题在已有文献中尚缺乏讨论。鉴于此，本文借鉴既往研究，基于2021年最新数据资料，以广西14个地市为研究对象，采用集聚度和数据包络分析方法分别定量测算广西基层卫生资源配置公平性和效率，进一步利用空间自相关分析方法分别描述两者各自的空间分布格局。基于以上研究结果，可进一步丰富和拓展相关文献，为优化广西基层卫生资源配置提出一些可供操作的政策和规划建议，同时为其他欠发达地区提供借鉴。
1　资料与方法
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1.1　数据来源与指标选取
本研究所需数据均来源于2022年《中国统计年鉴》《中国卫生健康统计年鉴》《广西统计年鉴》《广西卫生健康统计年鉴》。衡量基层卫生资源投入公平性方面，本文以全国及广西各地市的地理面积、人口数以及基层卫生机构、机构床位、人员数为原始数据；测算基层卫生资源配置效率时，选取基层卫生机构床位数和人员数作为投入指标，诊疗人次数和入院人数作为产出指标。
1.2　研究方法
1.2.1　集聚度
参考以往研究[4-5]，本文分别计算2021年广西及其14个地市人口集聚度（population agglomeration degree，PAD）和各指标下的卫生资源集聚度（health resources agglomeration degree，HRAD），将卫生资源集聚度与人口集聚度进行对比，以分析2021年广西基层卫生资源配置的公平性。当HRAD大于1时说明卫生资源按地理配置公平性相对较高，小于1时则说明相对较差。当HRAD/PAD大于1说明集聚的卫生资源较集聚的人口相对过剩，小于1则说明相对不足。
1.2.2　数据包络分析
数据包络分析（data envelopment analysis，DEA）是一种基于被评价对象间相对比较的非参数技术效率分析方法，在医疗卫生效率评价领域得到广泛的应用[6]。考虑到医疗机构投入产出规模报酬变化不定[7]，本文采用投入导向的BCC模型对2021年广西及其各地市的基层卫生资源配置效率进行分析和评价。
BCC模型将决策单元的综合技术效率（简称“综合效率”）分解为纯技术效率和规模效率[6]。其中，综合效率用以判断决策单元是否有要素上的浪费，纯技术效率可以衡量由管理和技术等因素影响的生产效率是否达到最优，规模效率可以衡量在投入导向下资源是否处于最优规模。各指标值取值范围为0～1，各指标值均等于1即为效率有效；纯技术效率为1，综合效率与规模效率小于1，表示DEA弱有效；若三个值均小于1，表示DEA无效。
1.2.3　空间自相关分析
空间自相关分析是一种空间上研究某一要素属性值与其相邻空间要素属性值是否显著关联的方法，包括全局和局部空间自相关分析，最常用的关联指标是Moran I [8-9]。全局空间自相关分析可用于描述属性值在整个区域的空间特征，而局部空间自相关分析是将全局空间自相关分析分解到局域空间上，揭示每一个空间单元与邻近单元就某一属性的相关程度，用于进一步探测空间集聚或离散的位置及范围。
Moran I一般取值范围为-1～1，其大于0表示空间正相关，小于0表示空间负相关，取值为0时表示空间不相关，通常采用Z得分和P值来反映其显著性水平。根据局部Moran I指数的显著性水平和Z（I）的符号可将研究单元划分为四种聚类类型：当局部Moran I的值为正，Z得分为正时，为高-高型；而当Z得分为负时，为低-低型；当局部Moran I的值为负，Z得分为正时，为高-低型；Z得分为负时，则为低-高型。本次研究选取Moran I研判广西基层卫生资源配置公平性与效率相关数据指标可能存在的全局和局部空间自相关性。
1.3　统计学处理
通过MS Office 2019建立数据库，测算人口集聚度及各指标下的卫生资源集聚度，以分析广西基层卫生资源配置公平性；依据BCC模型，使用DEAP 2.1软件计算广西基层卫生资源配置效率；采用GeoDa 1.20.0软件作为空间计量统计工具，进一步分析广西基层卫生资源配置公平性和效率的全局和局部空间自相关状况。检验水准α=0.05。
2　结果
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2.1　公平性分析
2021年，广西基层卫生机构、卫生机构床位、卫生人员的集聚度均远大于1，各地市基层卫生资源集聚度分布在0.451～2.961之间，基层卫生资源集聚度与人口集聚度的比值为0.687～1.542。见表1。
2.2　效率分析
2021年，广西基层卫生资源综合效率、纯技术效率、规模效率均接近于1，处于DEA有效、弱有效、无效的地市分别有4个（占比28.57%）、2个（占比14.29%）、8个（占比57.14%）。见表2。
2.3　空间自相关分析
2.3.1　全局自相关分析
全局空间自相关分析结果显示，2021年广西基层卫生资源纯技术效率的全局Moran I为0.154，Z得分为2.956（大于1.96），P值为0.007（小于0.05），结果具有统计学意义，说明其在空间上呈较强的正相关性，主要表现为纯技术效率相近的地市在空间上趋于相邻；其余指标的Z值均介于-1.96与1.96之间，在5%的水平下不显著，即不存在显著空间自相关关系，各市域单元之间的关联关系较弱。见表3。
2.3.2　局部自相关分析
局部空间自相关分析结果显示，除规模效率外，其余指标中均有小部分地市表现出具有统计学意义的空间相关性差异。见表4。
3　讨论
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3.1　广西基层卫生资源配置公平性地区差异大，呈一定空间聚集特征
集聚度结果显示，广西基层卫生资源配置整体公平性较好，按地理面积配置的资源相对按人口配置更为充足，这与黄丹琪[4]等学者的研究结论相吻合。具体到地市，基层卫生资源按地理面积配置较为集中的典型地区主要分布于南宁、北海、贵港、玉林4市，而另有6个地市的基层卫生资源按地理面积配置均处于相对不公平状态，存在资源短缺现象。这与《广西医疗卫生服务体系“十四五”规划》明确要求要实现“基本医疗卫生服务均质化”的目标相比，仍存在相当大的差距。广西未来应结合最新资源布局，注意避免不同地区机械使用同一个标准，在综合考虑各市人口分布情况、基层卫生服务半径等因素的基础上制定有针对、有区别的基层卫生财政投入政策[10-11]。
空间统计分析结果显示，按地理配置的基层卫生资源的全局空间自相关性没有统计学差异，说明广西14个地市在提高基层卫生资源配置公平性方面相互合作性不强。进一步局部自相关分析发现，仅有北海一个城市的基层卫生机构和人员公平性处于高-高聚集状态。北海作为广西北部湾经济区重要节点城市，应调节和扩大其与相关邻近地区的资源要素共享与深度合作，助力提高市际资源配置公平性。其他显著聚集地区在空间上均表现为低-高聚集类型，是基层卫生资源高聚集水平区向低聚集水平区辐射传导过程中的断层区域，这类地区应积极与邻近地区开展医疗卫生合作和寻求资源辐射，并加快推进基层医疗卫生机构标准化建设，推动远程医疗协作网的升级与延伸，科学引导社会办医院向基层延伸分支机构，方便群众就近获得优质有效的基本医疗和公共卫生服务[12]。
3.2　广西基层卫生资源配置效率空间差异显著，纯技术效率空间相关性明显
本文效率分析结果表明，广西基层卫生资源总量配置效率呈现优良状况，但综合效率达到最优地市的占比均没超过30%，且个别地市的效率值过低，这反映出市际间的效率差距较大，提示各地市须加强协作、帮扶，促进区域间的协同发展[13]。
空间自相关分析结果显示，广西基层卫生资源配置纯技术效率的空间自相关性具有统计显著性，部分地市综合效率的局部空间聚集效应呈现显著性，表明在要素空间集聚和扩散状态的基础上构建差异化的卫生规划将大有可为。
纯技术效率高-高型的柳州、桂林、梧州，对周边城市起到了正外部性示范带动作用，未来这些地区在保持先发优势的前提下，总结有效经验，积极发挥其知识、技术等要素的溢出效应，在有余力时进一步增强辐射面，加快广西地区基层卫生健康工作高质量发展的步伐[14]。崇左处于低-低聚集类型，基层卫生资源纯技术效率明显低于广西平均水平，其与邻近地市易形成纯技术效率皆低的空间关联倾向。崇左应主动打破区域界限，争取与高-高聚集地区促成长期合作，通过吸收人才外溢、借鉴先进经验，并结合自身发展情况优化基层管理模式、弥合区域技术“鸿沟”，以此形成新的空间聚集格局[15]。来宾的纯技术效率呈高-低聚集，应加强自身内涵建设，深入开展“优质服务基层行”活动，全面提升基层医疗服务能力，并联动周边低水平聚集区的共同发展，形成互利共赢的共同体，从而缩小区域差距。
此外，广西地区间基层卫生资源投入具有一定的自主性和差异性，城市与周围邻近城市的规模效率相互联系、影响的程度不强，这可能与各市经济之间属于竞争型空间关系有关[16]。基于此，应突显广西政府办医主体责任，适时提高对基层卫生机构补贴；发挥宏观调控作用，提高市级政府自身积极性，制定配套卫生政策，完善区域基层卫生资源共享机制，实现地区间资源优势互补与协调发展，更好服务于全区居民健康[17-18]。
3.3　广西基层卫生资源配置公平性和效率的空间分布格局有较大差异
从空间分布上看，广西基层卫生资源公平性与效率的局部关联模式存在显著的地区差异，归属于广西基层卫生资源公平性高-高型的城市与效率高-高型城市的不存在重合，公平性低-高聚集地区与效率低-高聚集地区也同样不存在重叠区域。这说明基层卫生资源配置公平性高的地区，并不意味着其资源配置效率水平一定高于其他地区，广西地区基层卫生资源同时达到高公平性配置与高效率配置还有一定距离。值得注意的是，梧州2021年基层卫生机构、机构床位、人员集聚度均呈低-高聚集，其基层卫生资源公平性低于周边城市平均水平，综合效率和纯技术效率反而为高-高聚集。这种位置的反转说明广西应重视地区间基层卫生资源配置公平性与效率不相适应的客观现象，决策者需着力于协调优化资源布局，以尽可能维护资源配置公平性为前提，依据现存的基层卫生服务供给量缺口调整资源投入，通过政策引导促进资源利用高水平发展[4]。
基金
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  • 2021年度广西特色新型智库联盟重点课题研究项目(GXZC2021-C3-001173-YZLZ)
文献
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2024年第51卷第1期
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doi: 10.20043/j.cnki.MPM.202305089
  • 接收时间：2023-05-08
  • 首发时间：2026-03-19
  • 出版时间：2024-01-10
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  • 收稿日期：2023-05-08
基金
2021年度广西特色新型智库联盟重点课题研究项目(GXZC2021-C3-001173-YZLZ)
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

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2种不同金属材料的力学参数
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genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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