新医改后乡镇卫生院设备配置公平性调查

Equity of medical device configuration in township health clinics since new medical reform

目的了解新医改以来山东省维坊市乡镇卫生院卫生设备配置公平性的变化情况和差异的主要来源。方法采用分层随机抽样法抽取山东省潍坊市8个市县的30家乡镇卫生院作为研究样本,利用泰尔指数对2009—2015年样本地区乡镇卫生院的设备配置情况进行公平性分析。结果 2009—2015年,样本地区设备配置泰尔指数在0.158 0~0.215 4,且总体呈下降趋势;区域内泰尔指数在0.076 4~0.137 7,年均值为0.109 3,对总体泰尔指数的贡献率均值为56.33%;区域间泰尔指数在0.101 7~0.071 1;年均值为0.083 7,对总体泰尔指数的贡献率均值为43.67%。结论新医改以来,基层医疗卫生机构的设备配置水平有所增强,公平性有所提高;相比县域之间设备配置公平性的差异,各县域内部不同乡镇卫生院之间设备配置的不公平是整个样本地区不公平的主要来源。

Objective To analyze the variation and difference in the equity of medical device configuration in town- ship health clinics since the implementation of new medical reform. Methods Relevant data were collected from 30 township health clinics selected with stratified random sampling from 8 districts or counties of Weifang municipality, Shandong province. Theil index was adopted to analyze the equity of medical device configuration among the clinics from 2009 to 2015. Results During the period,the Theil index for medical device configuration among the 30 clinics ranged between 0. 158 0 and 0. 215 4, with a decreasing tendency generally; the intragroup Theil indexs were in a range of 0. 076 4 -0. 137 7 ,with an annual mean of 0. 109 3 and an average group contribution ratio of 56. 33% to the overall in- dex,while the between-group Theil indexs were in a range of 0. 101 7 -0. 071 1 ,with an annual mean of 0. 083 7 and an average group contribution ratio of 43.67% to the overall index. Conclusion Since the implementation of new medical reform,the level and the equity of medical device configuration in grassroots medical institutions was generally im- proved ; the intra-townships difference was more significant than the between townships difference in the equity of medical device configuration in township health clinics.