我国城乡基本医疗卫生服务均等化及其影响因素研究

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作者	石树东
姓名汉语拼音	shishudong
学号	2020000001035
培养单位	兰州财经大学
电话	18408211312
电子邮件	916064320@qq.com
入学年份	2020-9
学位类别	学术硕士
培养级别	硕士研究生
学科门类	经济学
一级学科名称	理论经济学
学科方向	西方经济学
学科代码	020104
第一导师姓名	管新帅
第一导师姓名汉语拼音	guanxinshuai
第一导师单位	兰州财经大学
第一导师职称	教授
题名	我国城乡基本医疗卫生服务均等化及其影响因素研究
英文题名	Study on the equalization of urban and rural basic medical and health services and its influencing factors in our country
关键词	城乡基本医疗卫生服务均等化影响因素
外文关键词	Urban and rural; Basic medical care and health services; Equalization; Influencing factors
摘要	摘要基本医疗卫生服务关乎每位公民健康权利的实现。随着经济社会的发展，我国医疗卫生事业取得了巨大的成就，但城乡发展不平衡问题依然突出。当前我国社会主要矛盾已转变为人民日益增长的美好生活需要和不平衡不充分的发展之间的矛盾，人民对基本医疗卫生服务的需要体现了其对美好生活的需要，因而研究我国城乡基本医疗服务均等化发展水平及其影响因素具有重要意义。本研究梳理了新中国建国以来我国城乡基本医疗卫生服务制度变迁历程，基于 2007-2020 年 29 个省（市、自治区）的面板数据，通过构建综合评价指标体系运用熵值法和信息熵原理对我国 29 个省（市、自治区）城乡基本医疗卫生服务均等化水平进行了系统评估和比较分析，并采用 Dagum 基尼系数法对差异来源进行分解；进一步，运用空间面板计量模型对我国城乡基本医疗卫生服务均等化发展的影响因素进行实证分析。得出的主要结论有：（ 1）我国城乡基本医疗卫生服务制度变迁经历了曲折往复的发展过程。（ 2）2007-2020 年我国各省市城乡基本医疗卫生服务均等化水平都有不同程度的提升，不同区域之间存在着较大的区域异质性，东部地区均等化水平与全国其他三个区域均等化水平存在较大的差距，但其他三个区域均等化水平之间的差距较小。（ 3）2007-2020 年总体基尼系数呈现平稳下降趋势。虽然区域间差异贡献程度呈减弱态势，但其仍然是城乡基本医疗卫生服务均等化水平差异的主要来源，并远高于区域内差异和超变密度的贡献。（ 4）财政自给率、人均转移支付、城镇化率、经济发展水平、抚养比对城乡基本医疗卫生服务均等化水平有显著的促进作用；而政府支出偏好、地方政府竞争、市场化程度、对外开放程度、人口密度对城乡基本医疗卫生服务均等化水平正向作用不显著。基于以上研究结论，本文提出了以下几点建议：一是完善政府间财政分权体系，提高地方政府财政自给率；二是建立体现均衡性的转移支付制度，平衡地区间财力分配；三是坚持城乡统筹发展思想，积极推动以县城为重要载体的城镇化；四是坚持区域协调发展战略，缩小地区间发展差距。关键词：城乡基本医疗卫生服务均等化影响因素
英文摘要	Abstract Basic medical care and health services are related to the realization of every citizen's health right. With the development of economy and society, great achievements in the medical and health care area have been made, but the problem of unbalanced development between urban and rural areas is still obvious. At present, the principal contradiction in china society has turned into the contradiction between the people's growing needs for a better life and the unbalanced and inadequate development. The people's needs for basic medical and health services reflect their needs for a better life. Therefore, it is of great significance to study the development level of equalization of basic medical and health services in urban and rural areas and its influencing factors. This study has combed the changing process of the basic medical care and health service system in the urban and rural areas since the founding of the People’s Republic of China. Based on the panel data of 29 provinces (municipalities and autonomous regions) from 2007 to 2020, by constructing a comprehensive evaluation index system, entropy method and information entropy principle were used to systematically evaluate and compare the equalization level of basic medical care and health services in urban and rural areas, and Dagum Gini coefficient method was used to decompose the sources of differences. After that, the spatial panel measurement model is used to analyze the factors affecting the development of equalization of basic medical care and health services in urban and rural areas. The main conclusions are drawn: (1) The vicissitudes of basic medical care and health service system in urban and rural areas have experienced the zigzagging development process. (2) From 2007 to 2020, the equalization level of basic medical care and health services in urban and rural areas in all provinces and cities has been improved to varying degrees, and there is great regional heterogeneity among different regions. There is a large gap between the equalization level of the eastern region and the other three regions, but the gap between the other three regions is small. (3) The overall Gini coefficient showed a steady downward trend from 2007 to 2020. Although the contribution degree of inter-regional disparities shows a weakening trend, it is still the main source of the difference in the equalization level of basic medical care and health services between urban and rural areas, and it is much higher than the contribution of intra-regional disparities and supervariable density disparities. (4) Financial self-sufficiency rate, per capita transfer payment, urbanization rate, economic development level and dependency ratio have significant promoting effects on the equalization level of basic medical care and health services in urban and rural areas; However, government expenditure preference, local government competition, degree of marketization, degree of opening to the outside world, and population density have no significant positive effect on the equalization level of basic medical care and health services in urban and rural areas. Based on the above research conclusions, this paper puts forward the following suggestions: first, improving the inter-governmental fiscal decentralization system, improve the local government financial self-sufficiency rate; second, a balanced transfer payment system should be established to balance the allocation of financial resources between regions. Third, adhere to the idea of overall urban and rural development, and actively promote urbanization with county towns as an important carrier; fourth, adhere to the strategy of coordinated regional development and narrow the development gap between region Keywords:Urban and rural; Basic medical care and health services; Equalization; Influencing factors
学位类型	硕士
答辩日期	2023-05-21
学位授予地点	甘肃省兰州市
语种	中文
论文总页数	79
参考文献总数	55
馆藏号	0004769
保密级别	公开
中图分类号	F091.3/50
文献类型	学位论文
条目标识符	http://ir.lzufe.edu.cn/handle/39EH0E1M/33937
专题	经济学院
推荐引用方式 GB/T 7714	石树东. 我国城乡基本医疗卫生服务均等化及其影响因素研究[D]. 甘肃省兰州市. 兰州财经大学,2023.

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