上海市社区公共卫生服务资源配置公平性分析

The equity analysis of resource allocation of community health services in Shanghai

目的:采用基尼(Gini)系数和泰尔(Theil)指数对上海市社区卫生服务资源配置公平性进行评价,为社区卫生服务资源的合理配置提供科学依据。方法:对全市19个区(县)所有社区卫生服务中心(站)进行疾病社区综合防治工作情况问卷调查。计算社区卫生服务团队、卫生技术人员和政府拨付经费按人口和面积配置的Gini系数和Theil指数,并对Theil指数进行分解。结果:上海市社区卫生服务团队、社区公共卫生技术人员和政府投入社区公共卫生经费在人口配置上的Gini系数分别为0.2734、0.3165和0.2261,处于公平的最佳状态,在地域分布上均超过0.4,处于警戒状态。Gini系数和Theil指数变动趋势一致。结论:上海市社区公共卫生服务资源配置公平性总体值得肯定,但地理公平性需引起重视。

Objective： To evaluate the equity resource allocation in community public health services by Gini coefficient and Theil index,and provide scientific basis for optimal allocation of community public health resources.Methods： Questionnaire of community-based comprehensive prevention and control of diseases public were investigated in all the community health service in 19 districts,Shanghai.Gini coefficient and Theil index were public calculated on local population and area resource distribution.Results： The fairness of community public health in terms of local population resource distribution,such as service team numbers,health technical workers public and local governments investment with Gini 0.2375,0.2551 and 0.2562 at best status,but the fairness of community public health in terms of geographic resource distribution was on the borderline with Gini0.4.The equity of the Gini public coefficient was close to inequity danger status.The trends on Gini coefficient and Theil index were consistent.Conclusion： The community health services resource allocation in Shanghai is commendable as a whole,but the geographic equity should be pay more attention to.