Article(id=1324077867075773106, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202507391, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753113600000, receivedDateStr=2025-07-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614363688, onlineDateStr=2026-11-02, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614363688, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614363687, creator=13701087609, updateTime=1793614363687, updator=13701087609, issue=Issue{id=1324077716676424398, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614327830, creator='13701087609', updateTime=1793614418028, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078095132655884, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078095132655885, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=885, endPage=890, ext={EN=ArticleExt(id=1324077868938044083, articleId=1324077867075773106, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Construction of a three-stage TOPSIS-RSR-Markov chain model and its application in evaluating the service capacity of public traditional Chinese medicine hospitals in Shanxi Province, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective To construct a TOPSIS-RSR-Markov chain model to comprehensively evaluate the current situation of traditional Chinese medicine service ability in Shanxi Province and predict the dynamic evolution trend.
Methods Based on the data of public traditional Chinese medicine hospitals in 11 prefecture-level cities in Shanxi Province from 2021 to 2023, an evaluation system containing two first-class and ten second-class indicators was constructed. TOPSIS method and RSR method were used to rank the ability, and Markov model was used to predict the change trend from 2024 to 2025.
Results TOPSIS showed that Yuncheng (C=0.88), Jinzhong (C=0.75), Taiyuan (C=0.75) ranked the top three, and Shuozhou (C=0.10) ranked the bottom. The RSR method ranked Taiyuan (RSR=0.818) and Changzhi (RSR=0.75) in the highest grade. The two methods were moderately consistent (Spearman r=0.56). Markov prediction showed that the short-term capacity differentiation, the head agglomeration effect was enhanced, and some low- and medium-level cities were at risk of being downgraded. The proportion of low-level cities was stable at 25%. Sensitivity analysis confirmed that the core conclusions were robust, optimistic and structural optimization scenarios could increase the proportion of high-level cities, and pessimistic scenarios exacerbated the Matthew effect.
Conclusion The service ability of traditional Chinese medicine in Shanxi Province is characterized by “dynamic evolution in gradient differentiation”. It is necessary to implement the differentiation strategy of “leading by the head city-breakthrough by the central city-bottom out by the tail city” to accelerate the development of traditional Chinese medicine in Shanxi Province.
, authors=Jue WANG
1, Rui-feng LIANG
1, 2, 3, Ya-juan SUN
4, Wei NIU
4, Hu-ze LIU
4, authorsList=Jue WANG, Rui-feng LIANG, Ya-juan SUN, Wei NIU, Hu-ze LIU, authorCompany=null, correspAuthors=Rui-feng LIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077869718184628, articleId=1324077867075773106, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=TOPSIS-RSR-马尔可夫链的三阶段模型构建及其在山西省公立中医院中医药服务能力评估中的应用, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的 构建TOPSIS-RSR-马尔可夫链模型,综合评价山西省中医药服务能力现状并预测动态演变趋势。
方法 基于2021—2023年山西省11个地级市公立中医院数据,构建含2项一级、10项二级指标的评价体系,采用TOPSIS法、RSR法进行能力排名,通过马尔可夫模型预测2024—2025年变化趋势。
结果 TOPSIS 法显示运城(C=0.88)、晋中(C=0.75)、太原(C=0.75)居前三,朔州(C=0.10)居末;RSR 法将太原(RSR=0.818)、长治(RSR=0.75)归为最高档;两种方法排序中度一致(Spearman r=0.56)。马尔可夫预测显示短期能力分化,头部集聚效应增强,部分中低水平城市存降档风险,低水平城市占比稳定25%。敏感性分析证实核心结论稳健,乐观及结构优化情景可提升高水平城市比例,悲观情景加剧马太效应。
结论 山西中医药服务能力呈“梯度分化中动态演进”特征,需实施“头部城市引领-中部城市突破-尾部城市兜底”的差异化策略加速山西省中医药发展。
, authors=王珏
1, 梁瑞峰
1, 2, 3, 孙亚娟
4, 牛玮
4, 刘虎则
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王珏(1999—),女,硕士在读,研究方向:公共卫生方面的学习和研究
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1.山西医科大学公共卫生学院环境卫生学教研室,山西 晋中030619)]), AuthorCompany(id=1324077870108254904, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, xref=2., ext=[AuthorCompanyExt(id=1324077870116643513, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, companyId=1324077870108254904, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
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4.山西省中西医结合医院,山西 太原 030001)])], figs=[ArticleFig(id=1324077874302558947, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 1, caption=
Evaluation index system for traditional Chinese medicine (TCM) service capacity of TCM hospitals in prefecture-level cities of Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 一级指标 | 二级指标 | 指标类型 |
|---|
| 中医医疗卫生资源 | X1:中医医院数(家) | 基础指标 |
| X2:每千人口中医类别执业(助理)医师数(人) | 基础指标 |
| X3:每千人口公立中医医院床位数(张) | 基础指标 |
| X4:每万人口中医类别全科医生数(人) | 基础指标 |
| X5:中医药杰出人才(国医大师、全国名中医,人) | 优势指标 |
| X6:全国百强中医院数目(个) | 优势指标 |
| 中医医疗卫生服务 | X7:二级以上公立中医医院设置康复(医学科)的比例(%) | 基础指标 |
| X8:二级以上公立中医医院设置老年病科的比例(%) | 基础指标 |
| X9:居民中医类医疗机构年平均出院次数(次) | 基础指标 |
| X10:居民中医类医疗机构年平均就诊次数(次) | 基础指标 |
), ArticleFig(id=1324077874386445028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表1, caption=
山西省各地级市辖区内中医院中医药服务能力评价指标体系
, figureFileSmall=null, figureFileBig=null, tableContent=
| 一级指标 | 二级指标 | 指标类型 |
|---|
| 中医医疗卫生资源 | X1:中医医院数(家) | 基础指标 |
| X2:每千人口中医类别执业(助理)医师数(人) | 基础指标 |
| X3:每千人口公立中医医院床位数(张) | 基础指标 |
| X4:每万人口中医类别全科医生数(人) | 基础指标 |
| X5:中医药杰出人才(国医大师、全国名中医,人) | 优势指标 |
| X6:全国百强中医院数目(个) | 优势指标 |
| 中医医疗卫生服务 | X7:二级以上公立中医医院设置康复(医学科)的比例(%) | 基础指标 |
| X8:二级以上公立中医医院设置老年病科的比例(%) | 基础指标 |
| X9:居民中医类医疗机构年平均出院次数(次) | 基础指标 |
| X10:居民中医类医疗机构年平均就诊次数(次) | 基础指标 |
), ArticleFig(id=1324077874478719717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 2, caption=
Comparison of TCM service capacity of all public TCM hospitals in prefecture-level cities of Shanxi Province from 2021 to 2023(average)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | 中医医疗卫生资源 | 中医医疗卫生服务 |
|---|
| X1(家) | X2(人) | X3(张) | X4(人) | X5(人) | X6(个) | X7(%) | X8(%) | X9(次) | X10(次) |
|---|
| 太原市 | 12 | 0.179 | 1.057 | 0.047 | 6.667 | 2 | 76.070 | 69.517 | 0.024 | 0.603 |
| 大同市 | 9 | 0.075 | 0.526 | 0.040 | 0.000 | 0 | 66.670 | 70.373 | 0.005 | 0.337 |
| 朔州市 | 7 | 0.063 | 1.141 | 0.036 | 0.000 | 0 | 47.617 | 38.097 | 0.053 | 0.430 |
| 忻州市 | 16 | 0.078 | 0.909 | 0.050 | 0.000 | 0 | 57.477 | 34.803 | 0.013 | 0.258 |
| 吕梁市 | 14 | 0.084 | 0.739 | 0.107 | 0.000 | 0 | 62.857 | 37.300 | 0.014 | 0.285 |
| 阳泉市 | 3 | 0.094 | 0.601 | 0.013 | 0.000 | 0 | 44.443 | 55.553 | 0.013 | 0.358 |
| 晋中市 | 11 | 0.146 | 1.037 | 0.016 | 0.000 | 0 | 90.910 | 56.363 | 0.024 | 0.639 |
| 临汾市 | 18 | 0.123 | 1.028 | 0.052 | 0.000 | 0 | 81.483 | 44.443 | 0.018 | 0.538 |
| 长治市 | 13 | 0.169 | 1.270 | 0.050 | 0.000 | 2 | 74.357 | 53.850 | 0.026 | 0.447 |
| 晋城市 | 6 | 0.079 | 0.537 | 0.026 | 0.000 | 0 | 65.553 | 53.333 | 0.011 | 0.267 |
| 运城市 | 16 | 0.093 | 0.777 | 0.068 | 0.000 | 0 | 89.443 | 68.057 | 0.014 | 0.303 |
| 山西省平均值 | 11 | 0.107 | 0.875 | 0.046 | 0.606 | 0.364 | 68.807 | 52.881 | 0.020 | 0.406 |
), ArticleFig(id=1324077874550022886, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表2, caption=
山西省2021—2023年各地级市辖区内所有公立中医院中医药服务能力比较(平均值)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | 中医医疗卫生资源 | 中医医疗卫生服务 |
|---|
| X1(家) | X2(人) | X3(张) | X4(人) | X5(人) | X6(个) | X7(%) | X8(%) | X9(次) | X10(次) |
|---|
| 太原市 | 12 | 0.179 | 1.057 | 0.047 | 6.667 | 2 | 76.070 | 69.517 | 0.024 | 0.603 |
| 大同市 | 9 | 0.075 | 0.526 | 0.040 | 0.000 | 0 | 66.670 | 70.373 | 0.005 | 0.337 |
| 朔州市 | 7 | 0.063 | 1.141 | 0.036 | 0.000 | 0 | 47.617 | 38.097 | 0.053 | 0.430 |
| 忻州市 | 16 | 0.078 | 0.909 | 0.050 | 0.000 | 0 | 57.477 | 34.803 | 0.013 | 0.258 |
| 吕梁市 | 14 | 0.084 | 0.739 | 0.107 | 0.000 | 0 | 62.857 | 37.300 | 0.014 | 0.285 |
| 阳泉市 | 3 | 0.094 | 0.601 | 0.013 | 0.000 | 0 | 44.443 | 55.553 | 0.013 | 0.358 |
| 晋中市 | 11 | 0.146 | 1.037 | 0.016 | 0.000 | 0 | 90.910 | 56.363 | 0.024 | 0.639 |
| 临汾市 | 18 | 0.123 | 1.028 | 0.052 | 0.000 | 0 | 81.483 | 44.443 | 0.018 | 0.538 |
| 长治市 | 13 | 0.169 | 1.270 | 0.050 | 0.000 | 2 | 74.357 | 53.850 | 0.026 | 0.447 |
| 晋城市 | 6 | 0.079 | 0.537 | 0.026 | 0.000 | 0 | 65.553 | 53.333 | 0.011 | 0.267 |
| 运城市 | 16 | 0.093 | 0.777 | 0.068 | 0.000 | 0 | 89.443 | 68.057 | 0.014 | 0.303 |
| 山西省平均值 | 11 | 0.107 | 0.875 | 0.046 | 0.606 | 0.364 | 68.807 | 52.881 | 0.020 | 0.406 |
), ArticleFig(id=1324077874646491879, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 3, caption=
Comparison of TCM service capacity among public TCM hospitals across prefecture-level cities in Shanxi Province (TOPSIS method)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | 正理想解距离(D+) | 负理想解距离(D-) | 相对接近度(C) | 排序结果 |
|---|
| 太原市 | 16.158 | 48.263 | 0.749 | 3 |
| 大同市 | 26.790 | 42.371 | 0.613 | 4 |
| 朔州市 | 55.548 | 6.110 | 0.100 | 11 |
| 忻州市 | 49.341 | 18.647 | 0.274 | 10 |
| 吕梁市 | 44.081 | 21.765 | 0.331 | 8 |
| 阳泉市 | 51.505 | 20.750 | 0.287 | 9 |
| 晋中市 | 17.278 | 51.800 | 0.750 | 2 |
| 临汾市 | 28.456 | 41.112 | 0.591 | 6 |
| 长治市 | 24.829 | 36.909 | 0.598 | 5 |
| 晋城市 | 33.683 | 28.216 | 0.456 | 7 |
| 运城市 | 7.859 | 57.371 | 0.880 | 1 |
), ArticleFig(id=1324077874747155176, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表3, caption=
山西省各地级市辖区内所有公立中医院中医药服务能力比较(TOPSIS法)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | 正理想解距离(D+) | 负理想解距离(D-) | 相对接近度(C) | 排序结果 |
|---|
| 太原市 | 16.158 | 48.263 | 0.749 | 3 |
| 大同市 | 26.790 | 42.371 | 0.613 | 4 |
| 朔州市 | 55.548 | 6.110 | 0.100 | 11 |
| 忻州市 | 49.341 | 18.647 | 0.274 | 10 |
| 吕梁市 | 44.081 | 21.765 | 0.331 | 8 |
| 阳泉市 | 51.505 | 20.750 | 0.287 | 9 |
| 晋中市 | 17.278 | 51.800 | 0.750 | 2 |
| 临汾市 | 28.456 | 41.112 | 0.591 | 6 |
| 长治市 | 24.829 | 36.909 | 0.598 | 5 |
| 晋城市 | 33.683 | 28.216 | 0.456 | 7 |
| 运城市 | 7.859 | 57.371 | 0.880 | 1 |
), ArticleFig(id=1324077874835235561, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 4, caption=
Ranking results of TCM service capacity of TCM hospitals in prefecture-level cities of Shanxi Province(RSR method)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | RSR值 | RSR排名 | RSR拟合值 | 分档等级 |
|---|
| 太原市 | 0.818 | 1 | 0.846 | 3 |
| 大同市 | 0.414 | 8 | 0.458 | 2 |
| 朔州市 | 0.468 | 7 | 0.497 | 2 |
| 忻州市 | 0.414 | 9 | 0.416 | 2 |
| 吕梁市 | 0.482 | 6 | 0.534 | 2 |
| 阳泉市 | 0.364 | 10 | 0.365 | 2 |
| 晋中市 | 0.664 | 4 | 0.615 | 2 |
| 临汾市 | 0.677 | 3 | 0.666 | 2 |
| 长治市 | 0.75 | 2 | 0.736 | 3 |
| 晋城市 | 0.323 | 11 | 0.295 | 1 |
| 运城市 | 0.627 | 5 | 0.573 | 2 |
), ArticleFig(id=1324077874910733034, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表4, caption=
山西省各地级市辖区内中医院中医药服务能力分档排序结果(RSR法)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 城市名称 | RSR值 | RSR排名 | RSR拟合值 | 分档等级 |
|---|
| 太原市 | 0.818 | 1 | 0.846 | 3 |
| 大同市 | 0.414 | 8 | 0.458 | 2 |
| 朔州市 | 0.468 | 7 | 0.497 | 2 |
| 忻州市 | 0.414 | 9 | 0.416 | 2 |
| 吕梁市 | 0.482 | 6 | 0.534 | 2 |
| 阳泉市 | 0.364 | 10 | 0.365 | 2 |
| 晋中市 | 0.664 | 4 | 0.615 | 2 |
| 临汾市 | 0.677 | 3 | 0.666 | 2 |
| 长治市 | 0.75 | 2 | 0.736 | 3 |
| 晋城市 | 0.323 | 11 | 0.295 | 1 |
| 运城市 | 0.627 | 5 | 0.573 | 2 |
), ArticleFig(id=1324077875065922283, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 5, caption=
Final integration and grading results of TCM service capacity of cities in prefecture-level cities of Shanxi Province
, figureFileSmall=null, figureFileBig=null, tableContent=
| 最终分级 | 分级依据 | 纳入城市 |
|---|
| 高水平 | 双方法一致或单一方法高水平且优势指标突出 | 太原、晋中、运城、长治市 |
| 中水平 | 双方法一致或分歧城市核心指标无明显短板 | 大同、临汾、吕梁、朔州、忻州、阳泉市 |
| 低水平 | 单一方法低水平且核心指标短板明显 | 晋城市 |
), ArticleFig(id=1324077875166585580, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表5, caption=
山西省各地级市中医药服务能力最终整合分级结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 最终分级 | 分级依据 | 纳入城市 |
|---|
| 高水平 | 双方法一致或单一方法高水平且优势指标突出 | 太原、晋中、运城、长治市 |
| 中水平 | 双方法一致或分歧城市核心指标无明显短板 | 大同、临汾、吕梁、朔州、忻州、阳泉市 |
| 低水平 | 单一方法低水平且核心指标短板明显 | 晋城市 |
), ArticleFig(id=1324077875275637485, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=EN, label=Table 6, caption=
Probabilistic sensitivity analysis results of state transition matrix
, figureFileSmall=null, figureFileBig=null, tableContent=
| 分析情景 | 关键参数变动描述 | 2025年低/ 高水平比例(%) | 长期稳态分布 (低:中:高) | 主要结论 |
|---|
| 基准情景 | 基于文献与政策设定[19-20] | 24.3/32.9 | 25.0% :37.5% :37.5% | 区域差距部分固化,高水平城市群体扩大。 |
| 乐观情景 | 中水平升档+10% 低水平降档-10% | 19.8/38.3 | 20.0% :30.0% :50.0% | 政策干预显效,长期半数城市达高水平。 |
| 悲观情景 | 中水平降档+10% 高水平降档+10% | 29.9/27.3 | 33.3% :44.4% :22.2% | 马太效应加剧,高水平城市优势难维持。 |
| 结构优化情景 | 高水平维持+5% 低水平升级+5% | 21.6/35.8 | 21.4% :35.7% :42.9% | “固头部 + 提尾部”可减缓城市分化、提升整体水平。 |
), ArticleFig(id=1324077875363717870, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077867075773106, language=CN, label=表6, caption=
状态转移矩阵概率敏感性分析结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 分析情景 | 关键参数变动描述 | 2025年低/ 高水平比例(%) | 长期稳态分布 (低:中:高) | 主要结论 |
|---|
| 基准情景 | 基于文献与政策设定[19-20] | 24.3/32.9 | 25.0% :37.5% :37.5% | 区域差距部分固化,高水平城市群体扩大。 |
| 乐观情景 | 中水平升档+10% 低水平降档-10% | 19.8/38.3 | 20.0% :30.0% :50.0% | 政策干预显效,长期半数城市达高水平。 |
| 悲观情景 | 中水平降档+10% 高水平降档+10% | 29.9/27.3 | 33.3% :44.4% :22.2% | 马太效应加剧,高水平城市优势难维持。 |
| 结构优化情景 | 高水平维持+5% 低水平升级+5% | 21.6/35.8 | 21.4% :35.7% :42.9% | “固头部 + 提尾部”可减缓城市分化、提升整体水平。 |
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