我国卫生资源配置状况及公平性分析

Analysis of the Condition and Fairness of Health Resources Allocation in China

目的分析我国各地区卫生资源配置的公平性,为促进卫生事业健康发展提供科学的依据。方法将我国分为东北、华北、华东、中南、西南和西北六个地区,使用Excel 2010描述分析各地区每千人口和每平方千米卫生资源配置,利用洛伦茨曲线(Lorenz curve)和基尼系数(Gini coefficient)分析卫生资源按人口和按地理分布的公平性。结果按人口分布的基尼系数均在0.2以下,分配绝对平均。按地理分布的基尼系数均在0.4以上,分配差距较大;其中卫生技术人员、执业医师和注册护士的基尼系数超过了0.5,分配差距悬殊。每千人口卫生资源配置,医疗卫生机构西北地区(0.93家)最高、华东地区(0.58家)最少,床位西南地区(5.95张)最高、华北地区(4.92张)最少;卫生技术人员西北地区(6.7人)最高、西南地区(5.73人)最少,执业医师华北地区(2.26人)最高、西南地区(1.69人)最少,注册护士各地区差距较小。每平方千米卫生资源配置,床位华北地区(1.96张)最多、西北地区(0.19张)最少;卫生技术人员、执业医师和注册护士均是华东地区最高、西北地区最少,分别为3.10人和0.22人、1.01人和0.06人、1.31人和0.09人。结论我国人均卫生资源不足,需加大医疗卫生事业的投入;卫生资源配置每平方千米差异大于每千人口,卫生资源按地理分布的公平性较差,应对西北和西南地区进行扶持,以缩小地区间差异。

Objective To analyze the fairness of health resources allocation in various regions of China,and provide a scientific basis for promoting the healthy development of health care. Methods The regions of China were divided into six parts:Northeast,North China,East China,Central South,Southwest and Northwest.Excel 2010 was used to describe the health resources allocation of various regions per thousand populations and per square kilometer.The Lorenz curve and the Gini coefficient were used to analyze the fairness of the distribution of health resources by popu- lation and geography. Results The Gini coefficient according to geographical distribution was above 0.4,and the distribution gap was large,among them,the Gini coefficient of health technicians,practicing doctors and registered nurses exceeded 0.5,and the distribution gap was wide.For the allocation of health resources per 1 000 population,the highest was in the northwestern region(0.93),the lowest in East China(0.58)of medical institutions;The highest in the Southwest(5.95),and the lowest in North China(4.92)of the mount of beds;The highest was in the Northwest(6.7)and lowest in the southwest region(5.73 people)of the health technicians;The highest was in the North China region(2.26)and the lowest in the Southwest(1.69)of the mount of licensed doctors,and the gap between registered nurses was small.For the health resource allocation per square kilometer,the largest was in North China(1.96)and the lowest in Northwest China(0.19)of the mount of beds;Health technicians,licensed physicians and registered nurses were the highest in East China and the lowest in Northwest China,with 3.10 and 0.22 people,1.01 and 0.06,1.31 and 0.09,respectively. Conclusion The allocation of health resources is insufficient per capita and need to increase investment in medical and health services.The difference in the allocation of health resources per square kilometer is greater than that per thousand populations.The fairness of health resources is poor according to geographical distribution.Supporting the northwest and southwest regions should be carried out to narrow the diffe -rences between regions.