湖北省医疗卫生资源配置公平性分析

On Equity of Medical & Health Resources Allocation in Hubei Province of China

目的:了解湖北省2018年卫生资源配置的公平性及其影响因素,为制定和实施湖北省"十三五"深化医疗卫生体制改革规划提供依据。方法:收集2018年湖北省17地市的卫生机构、医护人员和床位数量,使用基尼系数和泰尔指数进行公平性评价。结果:主要医疗卫生资源按人口分布测算的基尼系数在0.1293～0.2529之间,而按面积分布测算则在0.3624～0.6463之间;将17个市分为两个组计算泰尔指数,按人口分布测算组内贡献率在64.35%～100%之间,而按面积分布测算组间贡献率则从51.69%～81.8%不等。结论:医疗卫生资源存在明显地理分布不平衡和结构性不公平,优质资源集中于武汉。卫生行政部门在制定医疗卫生资源配置标准时,应兼顾人口公平性、地理公平性和质量公平性,从而提高卫生资源的覆盖率和服务可及性。

The objective of the study is to find out the situation of medical and health resources allocation and influence factors in Hubei province in 2018 to better formulate the Thirteenth Five-Year Plan on deepening the reform of medical and health system in Hubei Province. Methods: Collecting the data concerning the number of health institutions, medical staff and hospital beds in 17 municipalities of Hubei province. The data are analyzed to assess the equity of the resources allocation with Gini Coefficient and Theil Index. Findings: The Gini Coefficient of medical and health resources allocation is 0.1293~0.2529 in terms of population distribution, but it becomes 0.3624~0.6463 in terms of geographical coverage. Theil Index is calculated by dividing the seventeen municipalities into two groups.In-group contribution rate is 64.35%~100% in terms of population distribution, while the rate is 51.69%~81.8% in terms of geographical coverage. Conclusion: The medical and health resources allocation is imbalanced geographically and structurally. High-quality resources are concentrated in Wuhan city. In allocating medical & health resources, the medical administrative officials should take three aspects into consideration to assure the equity in population,geography and quality in order to improve the coverage of medical resources and availability of medical services.