我国卫生系统绩效公平性研究

Study on the Equity of Chinese Health System Performance

目的:研究我国卫生系统绩效的公平性,为我国卫生系统加强提供依据。方法:基于WHO卫生系统绩效评价框架,利用国家卫生服务调查扩点省份数据和相对集中指数方法,从地区、收入、教育等维度研究我国不同地区和省份的卫生系统绩效不平等。结果:我国卫生系统健康状况和满意度方面集中指数一般不超过0.1,而经济风险保护在各个维度的相对集中指数总体在0.2以上,处于相对较高的水平。结论:我国卫生系统绩效健康和满意度方面公平性较好,但是经济风险保护不平等问题突出;卫生系统绩效呈现出弱势人群脆弱性,低收入和受教育水平人群受到健康冲击更严重。国家和地区层面需要更多的关注贫困地区以及弱势人群,给予更多的健康管理和医疗保障支持。

Objective： To Study the equity of Chinese health systems performance and provide evidence for strengthening health system. Methods： Based on WHO health systems performance evaluation framework, the provincial data of expanded pilots under the national health service investigation and relative concentration index （RCI） were used to study the inequality of Chinese health systems performance from regions, income and education, etc. Results： The RCI values were lower than 0.1 on health status and satisfaetion dimensions. The RCI of financial risks protection was higher than 0.2, which was at a respective higher level. Conclusion： The health performance of people with lower education and wealth were fragility and these people usually with health shocks. Therefore, the national and regional government should pay more attention on vulnerable group and provide more healthcare management and security support.