Research On Guangxi Health Service Utilization Based On Fairness And Efficiency

Objective:In this study,the utilization of outpatient and inpatient health services in Guangxi Zhuang Autonomous Region from 2018 to 2019 was used as the research object.The concentration index and data envelopment analysis method were used to evaluate the equity of health service utilization in Guangxi Zhuang Autonomous Region from 2018 to 2019.Health service operation efficiency,explore improvement strategies to improve the equity and efficiency of health service utilization,and provide theoretical basis and policy recommendations for Guangxi to improve health service utilization equity and optimize service efficiency.Method:Through searching the relevant literature,we can fully understand and summarize the current situation of domestic and foreign health service equity and efficiency research.On this basis,collect the outpatient and inpatient health care of various types of medical institutions and 14 cities in Guangxi Zhuang Autonomous Region from 2018 to 2019.The service uses data and uses descriptive analysis to analyze its current situation.Establish a database through Excel 2010,use Stata15.0 to calculate the concentration index of outpatient and emergency services and inpatient services in Guangxi from 2018 to 2019,in order to evaluate the fairness of health service utilization in Guangxi Zhuang Autonomous Region;and adopt the SPSS 22.0 systematic clustering ward method,Using the squared Euclidean distance as the measurement interval,draw a clustering pedigree map in the vertical direction,and sequentially classify the utilization of medical and health services in the 14 cities in Guangxi according to the number of permanent residents,administrative geographic area,economic development degree,and health resource occupancy.Combining the results of cluster analysis to analyze the equity of health service utilization in areas with different permanent populations,different administrative geographic regions,different levels of economic development,and different levels of health resource allocation.The 14 prefectures and cities in Guangxi Zhuang Autonomous Region are regarded as 14 decision-making units,and the DEA(Data Envelopment Analysis)method is used to analyze the 14 prefectures and cities from 2018 to 2019,as well as different permanent populations,different administrative geographical divisions,different economic development levels,and different health The relative effectiveness of the allocation efficiency of medical and health resources in areas with the level of resource allocation Select the number of medical and health institutions,the number of beds,and the number of health technicians in 14 cities as input indicators,the number of visits and hospital admissions as output indicators,and use the output-oriented VRS model to use DEAP 2.1 software to carry out DEA data packets Network analysis.Results:1 In terms of the current status of health service utilization:(1)The number of Internet consultations in Guangxi in 2019 increased by 111.6% compared with 2018.The utilization rate of outpatient health services in primary medical and health institutions has declined,and the number of observing cases in the observation room has dropped by 36.7%.(2)The number of hospital admissions in primary medical and health institutions and the number of admissions per 100 outpatient emergency departments increased by 17.77% and 15.33%,respectively.The rate of decrease in hospital admission mortality of various types of medical institutions was 5%,5.55%,4.6%,and 3.64%,respectively.(3)In 2019,the number of general outpatient and emergency visits in the 14 prefectures and cities in Guangxi varied from 7.28% to 43.22%,and the number of observing cases in the observation room of each city varied from-77.29% to138.05%;the number of physical examinations varied from-23.95%-17.46%.(4)In 2019,the number of hospital admissions and the number of hospital admissions per 100 emergency departments in 14 prefectures and cities in Guangxi increased by 8.29%-19.97% and 0.58%-17.82% respectively from the previous year.The number of discharged patients per bed,average length of hospital stay,bed utilization rate,and mortality rate in 14 cities were-3.77%-9.81%,-3.38%-8.8%,-2.09%-6.31%,and-0.07%-0.05%,respectively.2 The fairness of health service utilization:(1)The fairness of outpatient health service utilization: The number of admissions,the number of surgeries,the number of emergency admissions per 100 outpatients,the number of discharges per bed,and the average concentration index value of hospitalization days in Guangxi in 2018 were 0.150 and 0.320,respectively,-0.058,-0.019 and0.038,the corresponding values in 2019 are 0.144,0.192,-0.062,-0.018 and0.030,respectively.(2)Equity of utilization of inpatient health services: The number of hospital admissions,the number of surgeries,the number of emergency admissions per 100 outpatients,the number of discharges per bed,and the average concentration index value of hospitalization days in Guangxi in2018 were 0.150,0.320,-0.058,-0.019,and 0.038,respectively,The corresponding values in 2019 are 0.144,0.192,-0.062,-0.018 and 0.030 respectively.(3)The value of the concentration index of Internet diagnosis and treatment in the whole region in 2018 and 2019 and the concentration index of areas with medium occupation of health resources in 2018 exceeded 0.5,respectively 0.645,0.644 and 0.745,the concentration index of regions with low health resources The value is-0.490.3 In terms of health service efficiency: from 2018 to 2019,each classified area is in a valid or weakly effective state of DEA;in 2018,Wuzhou,Hechi City and Laibin City’s DEA scale efficiency and pure technical efficiency are all less than 1,which is in DEA invalid state;The DEA scale efficiency and pure technical efficiency of Wuzhou,Qinzhou,Hechi and Chongzuo are all less than1,which is in a state of ineffective DEA.Conclusion and Recommendations:Conclusion :(1)In 2019,the growth rate of outpatient and emergency services in primary medical and health institutions decreased,and the growth rate of inpatient services was faster;(2)The fairness of inpatient health services in the whole district was better than that of outpatient services,and the unfairness of outpatient and emergency services increased.(3)The fairness of Internet diagnosis and treatment services needs to be improved,and there are differences;(4)The allocation of medical and health resources in most areas is efficient,and the medical and health resources in some cities are underutilized.Recommendations:(1)Improve the level of diagnosis and treatment in primary medical institutions,and increase the attractiveness of outpatient visits in primary medical and health institutions;(2)Improve the level of outpatient medical insurance benefits,and improve the fairness of outpatient health services;(3)Develop "Internet +" medical care to improve The fairness of Internet diagnosis and treatment;(4)Reasonably increase the input of medical and health resources,and improve the efficiency of comprehensive allocation of health resources.