广西卫生资源配置公平性和服务利用流向研究

Research on equity of health resource allocation and service utilization trend in Guangxi

[目的]分析2017年广西卫生资源配置公平性和服务利用流向情况,为优化广西卫生资源配置,完善分级诊疗制度提供参考和决策依据。[方法]运用基尼系数和泰尔指数从人口、地理、经济3个维度对卫生资源配置的公平性进行分析;运用描述统计法对医疗机构卫生资源分布和服务利用情况进行分析。[结果]各项卫生资源按人口、地理和经济计算的基尼系数分别为0.0965~0.1494、0.2890~0.3338和0.1228~0.2615之间,总泰尔指数在0.0064~0.0792之间,其中按人口分布的泰尔指数最小,按地理分布的泰尔指数最大,组内差异对泰尔指数的贡献率高于组间差异;各项卫生资源的增长率医院高于基层医疗卫生机构,医院医师的工作量比基层医疗卫生机构大,患者就医仍趋向流向医院。[结论]广西卫生资源人均量不足,区域性差异大,卫生资源按地理分布的公平性相对较差,卫生资源配置和服务利用下沉不明显。

Objective By analyzing the fairness of health resource allocation and service utilization trend in Guangxi in 2017,this paper hopes to provide reference and decision-making basis for optimizing the allocation of health resources and improving hierarchical diagnosis and treatment system in Guangxi.Methods The Gini coefficient and Theil index were used to analyze the fairness of health resource allocation from three dimensions of population,geography and economy.The distribution and service utilization of health resources in medical institutions were analyzed by descriptive statistics.Results The Gini coefficients of health resources calculated by population,geography and economy were between 0.0965~0.1494,0.2890~0.3338和0.1228~0.2615 respectively.The total thiel index was between 0.0064 and 0.0792,among which the thiel index is the smallest by population and the largest by geography.The contribution rate of intra-group differences to the thiel index was higher than that of inter-group.Conclusions The per capita amount of health resources in guangxi is insufficient,and the regional differences are large.The fairness of health resources according to geographical distribution is relatively poor,and the sink of health resources allocation and service utilization is not obvious.