2004—2015年我国卫生人力资源配置公平性趋势研究

Equity in the Distribution of Human Resources for Health in China during 2004—2015

目的探讨2004—2015年我国卫生人力资源配置的公平性及发展趋势。方法以2005—2016年《中国统计年鉴》、2005—2013年《中国卫生统计年鉴》以及2014—2016年《中国卫生和计划生育统计年鉴》为资料来源,收集2004—2015年我国卫生技术人员数、执业(助理)医师数及注册护士数。分析我国卫生人力资源配置的基本情况及变化趋势,并采用基尼系数、阿特金森指数、泰尔指数进行公平性分析。结果 2004—2015年我国卫生技术人员数、执业(助理)医师数、注册护士数分别增长了3 521 554、1 039 678、1 933 036名,年均增长率分别为5.41%、3.88%、8.60%;每千人口卫生技术人员数、执业(助理)医师数、注册护士数分别增长2.27、0.63、1.37名,年均增长率分别为4.62%、3.11%、7.99%;每千公顷地理面积卫生技术人员数、执业(助理)医师数、注册护士数分别增长5.21、1.54、2.80名,年均增长率分别为5.50%、3.95%、8.58%。2004—2015年,我国卫生技术人员数、执业(助理)医师数、注册护士数按人口分布的基尼系数分别为0.136~0.074、0.140~0.078、0.169~0.085;按地理面积分布的基尼系数分别为0.580~0.591、0.569~0.596、0.591~0.600。按人口分布的阿特金森指数分别为0.906~0.902、0.906~0.902、0.908~0.902;按地理面积分布的阿特金森指数分别为0.892~0.900、0.877~0.890、0.915~0.938。按人口分布的泰尔指数分别为0.033~0.011、0.034~0.011、0.052~0.013;按地理面积分布的泰尔指数分别为0.616~0.640、0.592~0.650、0.660~0.663。结论 2004—2015年,我国卫生人力资源总量持续增长,按人口分布的公平性优于按地理面积分布的公平性,卫生技术人员数、执业(助理)医师数分布的公平性优于注册护士数。应加大护理队伍人才建设,在对卫生人力资源配置统筹规划时注重地理面积因素。

Objective To investigate the distribution equity and developmental trend of human resources for health in China from 2004 to 2015.Methods The number of health professionals,licensed(assistant)doctors,and registered nurses in China from 2004 to 2015 was collected from 12 volumes of China Statistical Yearbook(2005-2016),9 volumes of China's Health Statistical Yearbook(2005-2013)and 3 volumes of China's Health and Family Planning Statistical Yearbook(2014-2016).We analyzed the general status and developmental trend of human resources for health,and explored its distribution equity by using Gini coefficient,Atkinson and Theil indices.Results Compared with 2004,the number of health professionals,licensed(assistant)doctors,registered nurses in China in 2015 increased by 3 521 554,1 039 678 and 1 933 036,respectively,with an average annual growth rate of 5.41%,3.88%,8.60%,respectively during 2004-2015;the number of health professionals,licensed(assistant)doctors and registered nurses per 1 000 population in 2015 increased by 2.27,0.63 and 1.37,respectively,with an average annual growth rate of 4.62%,3.11%and 7.99%respectively between 2004 and 2015;the number of health professionals,licensed(assistant)doctors and registered nurses per 1 000 hectares in 2015 increased by 5.21,1.54 and 2.80 respectively,with an average annual growth rate of 5.50%,3.95%and 8.58%,respectively between 2004 and 2015.From 2004 to 2015,the Gini coefficient for the distribution of health professionals,licensed(assistant)doctors,registered nurses by population was 0.136-0.074,0.140-0.078,0.169-0.085,respectively;and that for the geographic distribution of health professionals,licensed(assistant)doctors,registered nurses was 0.580-0.591,0.569-0.596,0.591-0.600,respectively.During 2004-2015,Atkinson index for the distribution of health professionals,licensed(assistant)doctors,registered nurses by population was 0.906-0.902,0.906-0.902,0.908-0.902,respectively;and that for the geographic distribution of health professionals,licensed(assistant)doctors,registered nurses was 0.892-0.900,0.877-0.890,0.915-0.938,respectively.Theil index for the distribution of health professionals,licensed(assistant)doctors,registered nurses by population during the period was 0.033-0.011,0.034-0.011,0.052-0.013,respectively;and that for the geographic distribution of health professionals,licensed(assistant)doctors,registered nurses was 0.616-0.640,0.592-0.650,0.660-0.663,respectively.Conclusion From 2004 to 2015,the number of health professionals had been increased gradually.However,its distribution equity by population was better than that of by geographic area;distribution equity of registered nurses was worse than that of health professionals or licensed(assistant)doctors.Therefore,team building for nurses should be strengthened,and equity of geographic allocation of human resources for health should be paid particular attention.