基于多维结构视角的区域公共卫生均等化分析——以江苏省为例

Analyzing the equalization of regional public health services in view of multidimensional structure sampled with Jiangsu Province

构筑一个包含投入和产出等多维结构的区域卫生均等化理论内涵体系。在此基础上,运用泰尔指数法对江苏2000-2010年期间卫生均等化水平及其演变规律进行实证分析。结果表明,江苏公共卫生发展总体存在着多维结构不平等状况,既存在卫生财政投入和卫生人力、物力资源投入层面不平等,同时存在着卫生服务质量等产出层面的不平等,但后者波动性要大于前者;进一步比较发现,不同区域卫生不平等的形成结构迥异,相比而言,经济发达的苏南地区近年来卫生不平等演变受政府财政卫生投入波动影响明显,而经济欠发达的苏北地区卫生不平等的加剧则主要由缺乏有效医疗服务市场竞争而导致的卫生服务质量差距所推动。

The theory system of equalization of regional public health services with a multidimensional structure involving input and output was developed. Based on which, the status and development of equalization of regional public health services in Jiangsu from 2000 to 2010 were empirically analyzed with Theil index. The results showed that the development of public health services in Jiangsu Province was multidimensional＇structurally unequal, which included inequality both in financial input, man- power and material resources input, and in output as the quality of health services. And the volatility of the latter was greater than that of the former. Further study showed that the formation of inequality in the structure of different regional health services was distinct. In recent years, the status of inequality in developed Southern Jiangsu was obviously influenced by the governmental fi- nancial input in health services. While the inequality in underdeveloped Northern Jiangsu aggravated mainly by the disparity in health services quality resulting from lacking effective market competition in medical services.