卫生资源配置公平性的基尼系数分析

Analysis on the Equity of Health Resource Configuration in Hangzhou

目的对杭州市2004—2010年卫生资源配置的公平性进行评价,为卫生资源的优化配置提供依据。方法对2004—2010年杭州市卫生资源相关数据,从人口分布和地理分布层面,以卫生机构、医生、床位为主要因素,采用洛伦茨曲线和基尼系数,分析卫生资源配置的公平性。结果 2004—2010年杭州市卫生资源量总体呈缓慢增加,卫生资源主要集中在杭州市区,杭州市内各区卫生资源存在差异。杭州市卫生资源按人口分布的基尼系数在0.2以下,达到最佳公平状态;但按地理分布的基尼系数已达0.6,处于警戒或高度不公平状态。结论杭州市卫生资源配置总体分布不平衡,卫生资源按人口配置的公平性高于按地理分布的公平性,卫生机构配置的公平性最优,医生配置公平性次之,床位数配置公平性较差。

Objective To evaluate the equity of health resource configuration in Hangzhou city during 2004 and 2010,providing the scientific evidence for health administrative sectors to optimize allocation of health resources.Methods Lorenz curve and Gini coefficient were used to measure the equity of health resource configuration from population and geographic distribution levels based on the data of health resources in Hangzhou.Results The amount of health resources in Hangzhou has increased slowly in the last six years.Health resources were mainly concentrated in urban areas,and the distributions varied in different districts.The Gini coefficient analyzed by population distribution was 0.2,achieving the best condition.However,when measured by geographic distribution,the coefficient was 0.6,indicating a state of alert or highly unfair.Conclusion The overall distribution of health resources in Hangzhou city is not equitable.The personal allocation of the health resources is better than the geographic allocation.The health institutions have the optimal configuration,the doctor configuration follows,and the bed configuration has the worst equity.