基于基尼系数和差别指数的北京市卫生资源配置公平性分析

Analysis on equity of Beijing's health resource allocation based on Gini coefficient and index of dissimilarity

目的了解北京市卫生资源配置公平性状况及发展趋势,为实施区域卫生规划、优化卫生资源配置提供参考依据。方法运用基尼系数、卫生资源密度指数(HRDI)和差别指数,对2015年北京市卫生资源按人口和地域面积配置的公平性进行分析。结果各类卫生资源人口分布、地理分布以及按HRDI计算的基尼系数分别为0.060~0.120、0.650~0.730和0.230~0.310。注册护士的基尼系数和差别指数均最高;卫生资源地理配置的基尼系数和差别指数高于人口配置。与床位资源分布的公平性相比,卫生人力资源分布的公平性相对较差。结论 2015年北京市物力资源配置优于人力资源,注册护士配置公平性较差;卫生资源人口配置优于地理配置;地区间资源配置差距较大;建议继续加大卫生投入力度、强化政策引导、重点优化卫生人力资源的区域配置和内部结构,以此提高资源配置公平性。

Objective To acquire the current equity situation and development trend of health resource allocation in Bei- jing so as to provide reference evidence for implementing regional health plan and optimizing health resource allocation. Methods The equity of health resource allocation in population and geography of Beijing in 2005 was assessed by Gini coefficient, HRDI and index of dissimilarity. Results The Gini coefficients for different kinds of health resource ranged from 0. 060 to 0. 120 in population, from 0.650 to 0.730 in geography and from 0.230 to 0.310 by HRDI. Both Gini coefficient and index dissimilarity of nurses were the highest in population and geography. Gini coefficient and index of dissimilarity in geography allocation of health resources were higher than those in population allocation. Besides, the equity of the hospital bed configuration was better than that of health human resources. Conclusion In 2015, the material resource allocation in health was better than human re- source allocation while the nurse allocation equity was poor in Beijing. The population allocation of health resources in health was better than the geography allocation. There were significant gaps among regions. To promote the equity of health resource alloca- tion, it was recommended to increase health investment, strengthen the guidance effect of health policy, optimize the geographic allocation and internal structure of health human resources.