With the aging of the population and the increase of the proportion of patients with chronic diseases, the people's demand for primary medical resources is diversified and complicated. There are differences in the demand for primary medical resources among different regions and different groups of people. Some areas are facing the problem of lack of primary medical resources, which seriously restricts the coverage and quality of primary medical and health services, and greatly affects the medical experience and health status of residents.

In order to promote the high-quality development of the primary medical and health service system, the health distance model is introduced to analyze the spatial and temporal evolution process of the allocation mismatch of primary medical resources in China from 2011 to 2021, so as to provide reference for rationally formulating regional health plans, optimizing the allocation of medical resources, improving the capacity of primary medical and health services, and promoting the high-quality development of medical and health services.

An evaluation index system for the mismatch of primary medical resources was established from the three levels of health material resources, human resources and security resources. Data were obtained from the China Statistical Yearbook and China Health Statistics Yearbook. The bi-level programming model and the health distance model were used to measure the mismatch of primary medical resources allocation from 2011 to 2021.

From 2011 to 2021, the overall mismatch degree of primary medical resources allocation in China has a significant downward trend, but the mismatch degree differences between regions and provinces continue to expand. The average values of mismatch in the eastern, central and western regions in 2011 were 0.633, 0.624 and 0.754, respectively, which were moderate mismatch, mild mismatch and severe mismatch. In 2021, the average values of mismatch in the eastern, central and western regions are 0.479, 0.522 and 0.639, respectively, which were moderate matching, mild matching and moderate mismatch.

Promoting the expansion of high-quality medical resources and promoting the balanced layout of regional medical resources are the premise of building a high-quality and efficient medical and health service system. In order to further optimize the allocation of primary medical resources and improve China's medical and health service system, we should formulate reasonable macro policies in combination with the characteristics of each region, improve the level of economic development, optimize the structure of fiscal expenditure, improve the administrative capacity of local governments, reduce the mismatch of primary medical resources allocation, and realize the high-quality development of primary medical and health service system.

随着人口老龄化和慢性病患者比例的增加，人民群众对基层医疗资源的需求呈多样化、复杂化的态势。不同地区、不同人群对基层医疗资源的需求存在差异，部分地区面临基层医疗资源匮乏的问题，严重制约基层医疗卫生服务的覆盖率和质量，极大影响居民的就医体验和健康状况。

为推动基层医疗卫生服务体系高质量发展，引入健康距离模型，分析2011—2021年我国基层医疗资源配置失配度的时空演变过程，为合理制订区域卫生规划、优化医疗资源配置方案、提高基层医疗卫生服务能力、推动医疗卫生服务高质量发展提供参考。

从卫生物力、人力、保障资源三个层面建立基层医疗资源失配度评价指标体系，从《中国卫生健康统计年鉴》《中国统计年鉴》获取数据，采用双层规划模型和健康距离模型测算2011—2021年基层医疗资源配置失配度。

2011—2021年我国基层医疗资源配置整体失配度有明显的下降趋势，但是区际、省际间失配度差异不断扩大。2011年东、中、西部地区失配度平均值分别为0.633、0.624、0.754，分别为中度失配、轻度匹配和重度失配。2021年东、中、西部地区失配度平均值分别为0.479、0.522、0.639，分别为中度匹配、轻度匹配和中度失配。

尽管我国基层医疗资源配置的整体失配度呈下降趋势，但仍然存在明显的差异，医疗资源配置的不均衡性仍在加剧。为持续优化基层医疗配置，推动基层医疗卫生服务体系高质量发展，提升我国医疗卫生体系的效能，需注重区域间资源配置的均衡性，因地制宜地制定差异化政策，以进一步优化医疗资源配置，提升基层医疗卫生服务的覆盖率和质量。