城乡医养结合资源配置差异分析——以咸宁市为例

Analysis of Urban-Rural Resource Allocation Differences in Integrated Medical and Elderly Care Services—A Case Study of Xianning City

摘要: 目的：分析咸宁市城乡医养结合机构在服务模式、床位资源、服务对象自理能力结构及人力资源配置上的差异，为优化区域资源配置提供实证依据。方法：基于咸宁市医养结合信息上报系统2025年3月数据，将咸安区划分为城市地区，其余县市为农村地区。采用描述性统计与χ²检验进行城乡比较，检验水准α = 0.05。结果：城乡均以“医办养”模式为主(20家，占68.97%)。城市每千老年人口床位为13.09张，农村为5.53张；城市床位利用率为76.02%，农村为43.20%，差异具有统计学意义(χ² = 360.52, P < 0.05)。完全失能老人占机构老人的49.61%，城乡失能结构分布差异显著(χ² = 61.018, P < 0.01)。农村康复治疗师仅占医疗服务人员的2.47%，城乡人力分布差异显著(χ² = 312.927, P < 0.01)。结论：咸宁市城乡医养结合存在显著的资源错配与供需结构失衡。建议构建跨区域床位调剂机制、实施差异化人力配置政策、引导社会资本参与，以提升资源利用效率。

Abstract: Objective: To analyze the differences in service models, bed resources, self-care ability structure of service recipients, and human resource allocation in integrated medical and elderly care institutions between urban and rural areas in Xianning City, providing an empirical basis for optimizing regional resource allocation. Methods: Based on data from the Xianning Integrated Medical and Elderly Care Information Reporting System as of March 2025, Xian’an District was classified as an urban area, while the remaining counties and cities were classified as rural areas. Descriptive statistics and chi-square tests were used for urban-rural comparison, with the significance level set at α = 0.05. Results: The “medical-establishing-elderly” model dominated both urban and rural areas (20 institutions, 68.97%). The number of beds per thousand elderly population was 13.09 in urban areas and 5.53 in rural areas; the bed utilization rate was 76.02% in urban areas and 43.20% in rural areas, with a statistically significant difference (χ² = 360.52, P < 0.05). Totally incapacitated elderly individuals accounted for 49.61% of institutionalized elderly, with a significant difference in the distribution of disability structures between urban and rural areas (χ² = 61.018, P < 0.01). Rehabilitation therapists in rural areas accounted for only 2.47% of medical service personnel, with a highly significant difference in human resource distribution (χ² = 312.927, P < 0.01). Conclusion: Significant resource mismatch and supply-demand structural imbalances exist in integrated medical and elderly care services between urban and rural areas in Xianning City. Recommendations include establishing a cross-regional dynamic bed resource adjustment mechanism, implementing differentiated human resource allocation policies, and guiding social capital participation to improve resource utilization efficiency.