Research On Equity And Efficiency Of Health Human Resources Allocation In Jilin Province

Objective:In this paper,the period from 2006 to 2020 is selected as the time range,and the units at different levels in Jilin Province are selected as the research object.From the perspective of exploring the supply-demand relationship of the allocation of health human resources in Jilin Province,the research is divided into two parts: In one part,the fairness of the allocation of health human resources in Jilin Province is analyzed from different dimensions.In the other part,the allocation efficiency is calculated by using the three-stage data envelopment analysis method after eliminating confounding factors.Promote the equitable allocation of health human resources among different regions,and realize the improvement of the allocation efficiency of health human resources,so as to provide data reference for the formulation of regional health personnel planning.Methods:1.Make a comprehensive review of relevant literature by literature research,sort out the indicators and research methods of health human resources mentioned in previous studies,and lay a foundation for subsequent studies.2.By referring to Jilin Statistical Yearbook from 2010 to 2021 and Jilin Provincial Health Statistical Yearbook from 2021,this paper obtains data of population,area and number of indicators in Jilin Province.In terms of population and geography: Descriptive analysis was used to describe the current situation of health human resources in Jilin Province,and the concentration degree was calculated to evaluate the equity of health human resources allocation.GIS spatial analysis and standard deviation ellipse were used to study the spatial distribution characteristics of the number of health workers in each region,and global and local Moran’s I were used to analyze the spatial autocorrelation.In the time dimension: the change trend of health personnel in the next five years is predicted by constructing a time series model.3.Efficiency analysis of health human resources allocation: three-stage DEA model was adopted for analysis.After removing environmental factors and random errors,the adjusted efficiency of input index value is obtained.Results:In terms of equity of health human resources allocation in Jilin Province:(1)Population dimension: Current situation analysis: Yanbian Korean Autonomous Prefecture had the maximum number of health technicians per thousand population(10.42);In terms of practicing(assistant)physicians per 1,000 population,Meihekou City had the highest number(4.15);In terms of practitioners per 1000 population,the highest value was in Meihekou City(3.59).Yanbian Korean Autonomous Prefecture had the highest number of registered nurses per 1,000population(4.51);In terms of pharmaceutical personnel per 1,000 population,Yanbian Korean Autonomous Prefecture and Baishan City were in the leading position(0.47).In terms of inspection personnel,the highest value was Baishan City(0.51);In terms of the ratio of medical care,the ratio of medical care in Baicheng city(1∶1.23)and Changchun City(1∶1.18)was relatively high.Fairness analysis: The agglomeration degree difference values of Jilin City and Baishan City are all greater than 0,while the agglomeration degree difference values of 5/6 indexes of Siping City,Liaoyuan City,Tonghua City and Songyuan City are less than 0.(2)Geographical dimension: Analysis of current situation: The number of health personnel per thousand kilometers in Tonghua City,Baishan City,Songyuan City,Baicheng City,Yanbian Korean Autonomous Prefecture and Changbai Mountain Management Committee is all less than 1.In Jilin City,Siping City,Liaoyuan City and Meihekou City,only the number of health technicians per thousand kilometers is more than 1,and other indicators are less than 1.Fairness analysis: The agglomeration degree value of all indexes of Changchun City,Jilin City,Liaoyuan City,Tonghua City and Meihekou City is greater than 1,while the agglomeration degree value of all indexes of Tonghua City,Baishan City,Songyuan City,Baicheng City,Yanbian Korean Autonomous Prefecture and Changbai Mountain Administrative Committee is less than 1.In GIS analysis of spatial and standard deviation ellipse results,Jilin Province presents the distribution situation with Changchun City or Jilin City as the center,dispersed and gradually decreasing in the four directions,and the direction is more obvious in the southwest direction.The results of global and local Moreland index indicate that Liaoyuan City,Siping City,Songyuan City and Changchun City are located in the first and third quadrants,and the other regions are located in the second and fourth quadrants.(3)Time dimension: predicted by ARIMA fitting model: The number of health personnel will continue to increase in the next five years,until 2025,the number of health technicians,licensed(assistant)physicians,licensed physicians,registered nurses,pharmaceutical personnel and laboratory personnel in Jilin Province will reach228,315,84675,108253,126208,11371 and 11318,respectively.In terms of allocation efficiency of health human resources in Jilin Province:After the three-stage DEA adjustment,from the perspective of Jilin Province,the overall efficiency of Jilin Province and all regions within the province are less than 1,and there is a significant gap between the results before the elimination of confounding factors.Technical efficiency and scale efficiency also declined,but the decline was smaller than scale efficiency.From the perspective of the whole country,the comprehensive efficiency value,technical efficiency value and scale efficiency value of Tianjin,Shanghai and the whole country are still 1 and there is little difference between them before adjustment.The comprehensive efficiency value,technical efficiency value and scale efficiency value of Beijing,Liaoning and Heilongjiang are less than 1,which is lower than the value before adjustment.Conclusions:(1)In general,the allocation of health human resources in Jilin Province is fairly fair and can meet the medical needs of the local population.But there are differences among urban units.(2)The spatial distribution of health workers in Changchun City and Jilin City is scattered in the southwest direction.(3)The number of health personnel shows a trend of continuous growth in the next five years.(4)The allocation efficiency of health human resources in Jilin Province needs to be improved.Compared with first-tier cities,there is a large gap and it is greatly affected by environmental factors,which can be improved through talent introduction or expansion.