Identifying the factors constraining the coupling coordination of primary medical resource allocation and high-quality economic development are essential for targeted promoting the coordinated development of the two system coupling. However, there are little research on the influencing factors that hinders the level of coordinated development of coupling.
To compare and analyze the coupling coordination level and its hindrance factors between primary medical resource allocation and high-quality economic development in China during the "12th Five-Year Plan" and the "13th Five-Year Plan" periods, identify barrier factors, and predict the coupling coordination trend of the two systems during the "14th Five-Year Plan".
The research was conducted from July 2022 to May 2023. The evaluation index system was constructed using 17 indicators, covering three dimensions from the primary medical resource allocation system (health equipment, health technicians, and healthcare funding) and five dimensions from the high-quality economic development system (innovation, coordination, openness, shared development, and green development). Data were sourced from the 2012-2021 China Statistical Yearbook and the corresponding China Health and Family Planning Statistical Yearbook. The entropy value method and comprehensive evaluation function were employed to assess the allocation of primary medical resources and economic high-quality development during the "12th Five-Year Plan" and "13th Five-Year Plan" periods. The coupling coordination model was constructed to facilitate this analysis. In order to ascertain the level of coupling coordination, an obstacle function was established in order to diagnose and identify obstacle factors affecting the coupling coordinated development. Furthermore, a grey model was employed in order to predict the trend of the coupling coordination of the two systems during the "14th Five-Year Plan" period.
The degree of coordination between the allocation of primary medical resources and high-quality economic development in China increased from 0.15 to 0.68 between the "12th Five-Year Plan" and the "13th Five-Year Plan" periods. This overall trend was observed to be increasing year by year. However, the coupling model exhibited a low level of coordination, despite the relatively fast growth rate. The main obstacles to the coupling level of primary healthcare resource allocation and economic high-quality development binary composite system in the "12th Five-Year Plan" and "13th Five-Year Plan" periods are health equipment, health technicians, shared and green development. The modified GM (1, 1) prediction model indicates that during the "14th Five-Year Plan" period, the coupling degree of the primary medical system and the economic development level system fluctuates around 1.00, and the whole system is in the stage of the coupling degree of coordination rises from 0.73 to 1.12, indicating a rising trend in the overall situation. Furthermore, the degree of relative development is greater than 1.20, which is indicative of an oversupply state.
In order to empower the development of grass-roots medical and health systems, it is recommended that the development concept of green sharing is recommended to promote the rationalization of medical resources from three aspects from promoting coordinated development of systems, improving the conditions of grass -roots medical facilities, opening up primary medical talents, and integrating primary medical resources.
General practitioners (GPs) are gatekeepers of residents' health, the rational allocation of resources is the basic guarantee for achieving fairness in health services. At present, research on the allocation of GPs in China mainly focuses on the whole country and individual provinces, lack of research on the allocation of human resources for general practitioners in the western region as the research object.
To comprehensively evaluate the current situation of GPs resource allocation in western China from 2015 to 2020, provide a reference for optimizing the resources distribution of GPs in the western region of China.
The data for this study were derived from the China Health and Family Planning Statistical Yearbook (2016-2017), the China Health Statistics Yearbook (2018-2022), and the China Statistical Yearbook (2016-2022). Using Atkinson index and location entropy to calculate and decompose the overall allocation of GPs resources in the western region. Using grey prediction model to predict the demand for GPs in the western region from 2022 to 2025.
From 2015 to 2020, the number of GPs in the western region increased from 39 290 to 94 652, with an average annual growth rate of 19.23%. The Atkinson Index by population, economy, and geography in 2015 and 2020 respectively were 0.1265 and 0.049 3, 0.124 4 and 0.038 2, 0.786 5 and 0.694 4. The location entropy of population, economy, and geographical indicators in the western provinces in 2020 respectively ranged from 0.794 3 to 1.219 0, 0.697 0 to 1.337 3, and 0.043 2 to 7.7270. The location entropy of geographical allocation in the southwest region is greater than 1, while the location entropy of population allocation in the northwest region is better than geographical allocation.The location entropy of economic indicators in Gansu, Qinghai and Guangxi is greater than 1 during the research period.The grey model predicts that the resources of GPs in the western region will show an increasing trend from 2022 to 2025.
The allocation level of GPs in the western region is gradually improving, and the structure is gradually optimizing. However, there are still problems such as insufficient total quantity, uneven distribution, low registration rate, and poor fairness. Suggestions should be based on geographical classification as the standard, with the principle of "Adjust increment and optimize inventory", the goal of occupational attractiveness, and the guidance of resource integration and regional collaboration to further optimize the resource allocation of GPs in the western region.
At present, chronic non-communicable diseases have become the major diseases affecting people's health in China. Most of the studies on resource allocation for chronic disease prevention and control are status quo surveys or equity analyses, and there is a lack of representative indicators for evaluating the results.
To analyze the changes of the appropriateness of resource allocation for chronic disease prevention and control in Chongqing, and to explore its impact on the effectiveness of chronic disease prevention and control.
In accordance with the principle of " exhaustiveness ", this study systematically collected all the literature in the field of chronic diseases in Chongqing from 2010 to 2021 published on the websites of the government, the Health and Planning Commission and its related departments, as well as on open databases such as the CNKI and the Web of Science, and a quantitative analysis was made on the appropriateness of resource allocation for the prevention and control of chronic diseases. After the systematic collection of information, this study was respectively carried out from the four secondary indicators and thirteen tertiary indicators of the appropriateness of resource allocation for chronic disease prevention and control, which was derived from the quantitative standards previously constructed by the research group. The "five-point scale" method was used to semi-quantitatively score the severity of the problem (0 points indicate that there is no problem, 5 points indicate that the problem is very serious) and the scores were further calculated to determine the appropriateness of resource allocation. Correlation analysis and linear regression were used to analyze the influence of the appropriateness of resource allocation on the prevention and control of chronic diseases.
From 2010 to 2021, the appropriateness of resource allocation for chronic disease prevention and control in Chongqing has increased from 6.64% to 27.57%; the appropriateness of human resource allocation has increased from 36.49% to 46.59%, the appropriateness of financial resource allocation has increased from 41.06% to 50.28%, the appropriateness of material resource allocation has increased from 41.40% to 42.96%, and the appropriateness of information resource allocation has increased from 5.73% to 24.09%. Among them, the appropriateness of financial and material resource allocation is significantly negatively correlated with the premature mortality rate of chronic diseases in Chongqing, with correlation coefficients of -0.722 and -0.586, respectively.
The appropriateness of resources allocation for the prevention and control of chronic diseases in Chongqing has been increasing year by year, but it is still at a lower level in general, and the main reason restricting its development lies in the relatively low information resources allocation; it is important to expedite the enhancement of the appropriateness of resources allocation to cope with the rapid increase of the number of chronic disease cases.
