武汉地区公立健康管理资源配置均衡性研究

Equilibrium Analysis of the Governmental Health Management Resources' Allocation in Wuhan Area

目的评价武汉地区公立健康管理资源配置的均衡性,为进一步改善公立健康管理资源配置提供参考。方法采用描述性研究、洛伦茨曲线、基尼系数、泰尔指数,分析2015年武汉市13个区216家公立健康管理机构、729位持证健康管理师数量的配置现状及均衡性。结果健康管理师基于服务人口和地域配置的基尼系数分别为0.467和0.580,泰尔指数为0.384和0.735;公立健康管理机构基于服务人口和地域配置的基尼系数分别为0.175和0.507,泰尔指数为0.051和0.621。城乡间差异是健康管理资源按面积配置不均衡的主要原因,贡献率为54.29%、83.89%;城区、农村各自内部差异是健康管理资源按人口配置不均衡的主要原因,贡献率分别为92.32%、84.62%。结论武汉地区公立健康管理资源配置失衡,呈现城乡、区域间资源分布不均现象,应进一步改善公立健康管理资源配置,尤其要加强农村地区的健康管理资源建设。

Objectives To evaluate the equilibrium of the allocation of resource among the governmental health management institutions and professionals,to provide references for improving public health resources allocation.Methods 13 counties in Wuhan were involved.Descriptive statistical method and Lorenz curve and Gini Coefficient were used to analyze the whole allocation of the 216 health management institutions and 729 professionals.Theil index was used to evaluate the differences of interregional allocation.Results According to the ground of the service population and geography,the distributions of professionals were relatively unfair.The Gini coefficients were 0.467 and 0.580 respectively,the Theil index were 0.384 and 0.735 respectively.Based on the population and geographical distribution,the allocation of governmental health management institutions＇ was relatively equal because the Gini coefficients was 0.175 and the Theil index was 0.051.But its allocation was poorly balanced because the Gini coefficients was 0.507 and the Theil index was 0.621 respectively.Basing on the area allocation,differences between urban and rural was the main reason for resources disparity,with contributing rate of 54.29% and 83.89%respectively.Basing on the population allocation,the main reason exist in urban group and rural group respectively,with contributing rate of 92.32% and 84.62% respectively.Conclusions There are two main reasons which influence the equilibrium of the allocation resource：one is the difference of the allocation between urban and rural area,another is the disproportionality which based on rural geographical area.It is necessary to improve the whole level of health management resource and distribution of rural area institution in Wuhan area,and enhance the service abilities of village clinics.