上海市社区卫生服务中心卫生技术人员配置公平性研究

Study on equity of health technician allocation in community healthcare centers in Shanghai

目的分析2017年上海市社区卫生服务中心(community healthcare center,CHC)卫生技术人员配置的公平性。方法描述上海市CHC卫生技术人员配置的整体概况,用Lorenz曲线、Gini系数、Theil指数从服务人口的维度分析CHC各类人员配置的公平性。结果除助理医师(0.527)与中医专科医师(0.455)外,其余各类人员配置的Gini系数均在0.1~0.3之间,配置的公平性总体较好,与Lorenz曲线分析结果一致。各类人员配置的Theil指数与Lorenz曲线、Gini系数有相同趋势,地区内贡献率(60.5%~99.3%)高于地区间贡献率(0.7%~39.5%)。结论全市CHC卫生技术人员配置的结构基本合理。CHC卫生技术人员按服务常住人口配置的公平性较好。各类卫生技术人员配置的地区内差异是引起相对不公平的主要原因。区域人口密度差异与资源跨区利用问题有待进一步研究。

Objective To analyze the equity of health technician allocation among community healthcare center(CHC)in Shanghai in 2017.Methods The overview of health technician allocation in CHC was described.The equality of health technician allocation in CHC was measured by Lorenz curve,Gini coefficient and Theil index.Results Gini coefficients of various types of health technicians were between 0.1 and 0.3 except for the assistant physicians(0.527)and the traditional Chinese medicine specialist physicians(0.455),consistent with Lorenz curve and indicating the overall equity.Theil index shared similar trend with Lorenz curve and Gini coefficients for all types of health technicians.The inequalities within divisions(which contributed about 60.5%to 99.3%among the total health technicians to the total Theil index)were higher than those among divisions(which contributed about 0.7%to 39.5%among the total health technicians to the total Theil index).Conclusion The health technician allocation in CHC is generally reasonable at the municipal level,and is generally equitable by population size.Differences among health technician allocation in intra-region are the main factor for relative inequality.Further studies on regional population density differences and cross-regional resource utilization need to be carried out.