广西县域卫生资源分布的不公平及其分解

Inequity and its Decomposition of Health Resources Distribution of Counties in Guangxi

目的考察广西县域卫生资源分布的不公平性及其影响因素。方法以广西110个县级行政区的卫生资源为研究对象,应用集中指数及其分解进行分析。结果广西县域医疗卫生机构床位、技术人员和执业(助理)医师的集中指数分别为0.1265、0.1826和0.2519;地区生产总值对县域卫生资源不公平性的贡献为正,贡献率在50.00%以上,尤其是对执业(助理)医师分布的不公平性贡献率达88.01%;人均生产总值指数对不公平性贡献为正,贡献率为18.88%~53.30%;地区生产总值指数对不公平性的贡献为负,贡献率为26.80%~79.48%;公共预算支出对卫生资源不公平性贡献为正,贡献率为17.99%~23.69%。结论广西县域卫生资源更多集中于社会经济状况较好的县域,其不公平性主要受县域经济发展水平、发展速度以及公共预算支出的影响;加快相对落后县域经济发展,增强经济社会发展与卫生资源发展的协调性,加大公共预算支出在卫生资源上投入,加强执业(助理)医师配置,有利于改善广西县域卫生资源分布的不公平性。

OBJECTIVE To investigate the inequity and its influencing factors of health resources distribution of counties in Guangxi.METHODS 110 counties were chosen as samples to study by the concentration index. RESULTS The concentration indices of beds,health technicians and practising(assistant) physicians in medical and health institutions were 0.126 5,0.182 6 and 0.251 9 respectively. GDP contributing positively to the inequality of health resources distribution of counties in Guangxi was over 50.00%, and especially it was at 88.01% for practising(assistant) physicians. Per capita GDP index contributing positively to the inequality was from18.88% to 53.30%. GDP index contributing negatively to the inequality was from 26.80% to 79.48%. Public budget expenditure positively contributed to the inequality, which was from 17.99% to 23.69%. CONCLUSION The health resources were more concentrated in counties with better socio-economic conditions. The inequity was mainly affected by the level of county economic development, the speed of development and public budget expenditure. Accelerating the economic development of relatively backward counties, enhancing the coordination between the economic and social development and the development of health resources, increasing public budget expenditure on health resources, and strengthening the allocation of practicing(assistant) doctors would be conducive to reduce the inequity of health resources distribution of counties in Guangxi.