乡村振兴背景下西部地区乡镇卫生院卫生资源配置公平性与效率研究

Equity and efficiency of health resource allocations in township health care centers in western region of China in the context of rural revitalization

目的研究乡村振兴背景下西部地区乡镇卫生院卫生资源配置公平性与效率,为完善西部地区乡镇卫生院卫生资源配置提供参考。方法应用基尼系数、泰尔指数分析乡镇卫生院卫生资源配置公平性变化,应用Malmquist指数模型分析其效率变化。结果2016年—2019年,西部地区乡镇卫生院卫生资源中,3项卫生资源配置公平性变化不明显,且区域内各省份之间的差异性是导致不公平的主要原因。Malmquist指数平均值为0.997,降低了0.3个百分点,西部地区中8个省份的Malmquist指数大于1,4个省份的Malmquist指数小于1,66.7%的省份增长和下降的主要原因是技术进步效率的变化。结论总体来看,2016年—2019年西部地区乡镇卫生院卫生资源配置的公平性和效率并没有得到明显的提升,西部地区应该采取多种措施促进乡镇卫生院卫生资源配置的优化,进而逐步提高整个西部地区基层医疗服务水平。

Objective To explore the equity and efficiency of health resource allocations in township health care centers in western region of China in the context of rural revitalization,and to provide evidence in the optimization of health resource allocations in these areas.Methods The Gini coefficient and Theil index were applied to analyze the changes in the equity of health resource allocations in township health care centers,and the Malmquist index(MI)was used to analyze the changes in the efficiency.Results From 2016 to 2019,the changes in the equity of the allocations of three aspects of health resources in township health care centers in the western region were not obvious,and the variability among provinces in this region was the main cause of inequity.The mean MI value was 0.997,decreased by 0.3 percent;and the MI was greater than 1 in 8 provinces and less than 1 in 4 provinces in this region,and the main reason for the increase or decrease in 66.7% of the provinces was the increase in efficiency due to technological progress.Conclusion Overall,the equity and efficiency of health resource allocation in township healthcare centers in the western region did not improve significantly in 2016-2019.More efforts should be made to optimize health resource allocation in township healthcare centers,so as to gradually improve the primary health care services in the whole western region.