治理研究 ›› 2025, Vol. 41 ›› Issue (2): 123-141.

• 浙江现象与经验 • 上一篇    下一篇

医疗服务供给水平的时空演进及驱动因素研究——基于浙江省的分析

秦上人   

  • 收稿日期:2024-08-14 出版日期:2025-03-15 发布日期:2025-05-09
  • 作者简介:秦上人,杭州师范大学公共卫生学院副教授、硕士生导师。
  • 基金资助:
    国家社科基金一般项目“共同富裕示范区医疗服务供给与经济社会的协同发展机制研究”(23BGL286)

Spatio-Temporal Evolution and the Driving Factors of Medical Service Supply Level—An Analysis of Zhejiang Province

Qing Shangren   

  • Received:2024-08-14 Published:2025-03-15 Online:2025-05-09

摘要:

提升地区医疗服务供给水平对人民健康与经济社会发展意义深远。浙江作为共同富裕示范区,其医疗服务供给发展演进逻辑与驱动机制的先行经验值得挖掘。基于空间分析理论与2013—2022年浙江省11个地级市的面板数据,采用熵权法对其医疗服务供给水平进行综合评价,使用空间自相关法分析医疗服务供给的时空演进轨迹,并运用空间计量模型进行驱动因素分析。结果表明,浙江共同富裕示范区医疗服务供给水平整体呈上升趋势,区域差异较大。医疗服务供给水平具有负向的空间自相关性,且医疗服务供给水平高值地区的辐射带动作用有待提升。城市化水平、教育支出对医疗服务供给水平有正向影响,城市人口密度则呈负向影响且具有负外部性,而对外开放程度具有正向外部性。共同富裕示范区医疗服务供给的经验表明,为促进医疗服务供给的提升,应优化空间医疗资源配置,医疗服务供给水平较高的地区应发挥空间辐射带动效应,同时合理推进城市化进程,重视公民健康教育、提升健康素养。

关键词: 医疗服务供给水平, 熵权法, 莫兰指数, 空间计量, 驱动因素

Abstract:

Enhancing regional medical services improves people's health and their economic and social development. This study examined panel data of the medical services supplied in 11 prefecture-level cities in Zhejiang Province from 2013 to 2022. The entropy weight method revealed the level of medical services in each city. The spatial and temporal evolution of medical services for each was also analyzed using the spatial autocorrelation method. Finally, a spatial econometric model was used to identify the factors driving service levels. The results show that the overall level medical services supplied in the Zhejiang Common Prosperity Demonstration Zone is on an upward trend, with large regional differences. The level of medical service supply has negative spatial autocorrelation, and the areas with high values of medical service supply do not play a radiation-led role. The level of urbanization and education expenditure has a positive impact on the level of medical service supply. Urban population density has a negative impact and negative externality, but the degree of openness to the outside world has a positive externality. The experience of medical service supply in the Common Prosperity Demonstration Zone shows that, in order to promote the improvement of medical services, the spatial allocation of medical resources should be optimised, and the areas with a higher level of medical service supply should play a spatial radiation-driven effect. At the same time, it is necessary to promote the process of urbanization and stress the importance of citizen health education and health literacy.

Key words: medical service supply level, entropy weight method, moran index, spatial econometrics, driving factors

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