1978-2017年云南省卫生资源配置公平性变化趋势分析

Analysis on the Equity Change Trend of Health Resource Allocation in Yunnan Province from 1978 to 2017

目的:探讨1978-2017年云南省卫生资源配置的公平性及变化趋势,为优化云南省卫生资源配置提供依据。方法:利用基尼系数从人口和地理配置两方面评价云南省40年卫生资源配置的公平性,运用非参数检验方法对其变化趋势进行分析。结果:1978-2017年云南省卫生资源增长迅速,床位数、卫生技术人员数、执业(助理)医师数按人口分布的基尼系数分别为0.125-0.320、0.183-0.305、0.213-0.297,40年来仅床位数的基尼系数呈显著的下降趋势;按地理分布的基尼系数分别为0.308-0.438、0.357-0.430、0.351-0.441,三者均呈显著上升趋势。2008年以后,无论按人口或地理分布的基尼系数均有所下降,床位数和卫生技术人员数变化趋势较显著,执业(助理)医师变化不显著。结论:40年来云南省卫生资源按人口配置的公平性优于按地理配置,按地理配置的公平性整体呈显著的上升趋势。前30年卫生资源公平性无显著改善,近10年床位数、卫生技术人员公平性有显著改善趋势。

Objective:To explore the fairness and changing trend of health resources allocation in Yunnan province from 1978 to 2017,and to provide basis for the optimal allocation of health resources in Yunnan province.Methods:Gini coefficient was used to evaluate the fairness of health resource allocation in Yunnan province from two aspects of population and geographical allocation,and non-parametric test was used to analyze its changing trend.Results:From 1978 to 2017,the health resources in Yunnan province grew rapidly.The Gini coefficient of the number of beds,the number of health technicians,and the number of practicing(assistant)doctors according to the population distribution were 0.125-0.320,0.183-0.305,and 0.213-0.297 respectively.The Gini coefficient of geographical distribution were 0.308-0.438,0.357-0.430 and 0.351-0.441,respectively,all of which show a significant upward trend.After 2008,the Gini coefficient declined in terms of population and geographical distribution.The number of beds and the number of health technicians showed a significant trend,while the number of practicing(assistant)physicians did not.Conclusion:In the past 40 years,the fairness of health resources allocation according to population is better than that according to geography.The fairness of health resources allocation according to geography shows a significant upward trend as a whole.There is no significant improvement in the equity of health resources in the first 30 years,but the number of beds and the equity of health technicians in the last 10 years show significant improvement trends.