内蒙古呼包鄂经济发展区近几年医疗卫生发展状况评价——基于TOPSIS-熵权法

Evaluation of Recent Medical and Health Development in Inner Mongolia’s Hohhot-Baotou-Ordos (Hubao’e) Economic Development Zone—Based on TOPSIS-Entropy Weight Method

摘要: 为系统评估区域一体化医疗政策的实施效果，本研究以内蒙古呼包鄂地区(呼和浩特、包头、鄂尔多斯)为对象，构建包含资源丰度、资源结构、服务能力与发展动态4个维度、7项指标的评价体系，运用熵权TOPSIS法对2019~2023年医疗资源配置水平进行动态综合评价。结果显示：2021年城乡居民大病保险统一政策实施后，区域医疗资源综合水平总体提升，2023年较2019年提高16.2%；2021年后区域差异在经历短期扩大后，于2022~2023年出现阶段性缩小，呈现“先扩后收”的初步收敛迹象。各市响应存在明显异质性：包头市综合得分增长27.21%，排名升至首位，但其以非公立医疗机构占比较高为特征的办医结构，在增强资源供给弹性的同时，也带来了行业监管、质量同质化和协同治理等方面的挑战；鄂尔多斯市增长21.78%；呼和浩特市相对优势减弱。研究表明，区域一体化政策可能通过资源再配置机制促进均衡发展，但关于区域差距“收敛”的判断仍属于基于短时间序列的阶段性观察，尚需更长时序数据进一步验证。基于此，本文提出差异化施策、强化社会办医监管、完善数据披露与优化评价体系等建议，以推动呼包鄂地区医疗卫生服务高质量协同发展。

Abstract: To systematically evaluate the implementation effect of regional integrated medical policies, this study takes the Hohhot-Baotou-Ordos region in Inner Mongolia as the research object, constructs an evaluation system covering four dimensions-resource abundance, resource structure, service capacity, and development dynamics-with seven indicators, and applies the entropy-weighted TOPSIS method to dynamically assess medical resource allocation from 2019 to 2023. The results show that after the implementation of the unified critical illness insurance policy for urban and rural residents in 2021, the overall level of regional medical resources improved, with the 2023 composite score 16.2% higher than that in 2019. Regional disparities first widened and then narrowed during 2022-2023, indicating only a preliminary sign of convergence rather than a confirmed long-term trend. City-level responses were heterogeneous: Baotou recorded a 27.21% increase in its composite score and ranked first, yet its structure characterized by a relatively high share of non-public medical institutions brings both opportunities for flexible supply expansion and challenges in regulation, quality control, and coordinated governance; Ordos increased by 21.78%; Hohhot’s relative advantage weakened. These findings suggest that regional integration policies may promote balanced development through resource reallocation, but the observed convergence should be interpreted cautiously and verified with a longer time series. Accordingly, this paper proposes differentiated policy measures, stronger supervision of social-sector health providers, better data disclosure, and an optimized evaluation framework to support high-quality coordinated development of medical and health services in the Hohhot-Baotou-Ordos region.