江苏省卫生资源区域配置现状及公平性研究

Current status and equity of regional health care resource allocation in Jiangsu Province

目的探索江苏省医疗卫生资源配置区域分布特征及公平性情况,以优化卫生资源配置。方法选取医疗服务设施、卫生人力资源两方面的5项指标,采用熵权TOPSIS法和泰尔指数对江苏省卫生资源配置水平及公平性进行分析。结果基于熵权TOPSIS法,江苏省13个城市中,南京卫生资源配置综合评价值C_(i)最高,为0.654,镇江最低,为0.153。在苏南、苏中、苏北三大区域中,苏南地区综合评价值C_(i)最高,为0.577。基于Theil指数,5项指标中Theil指数最高的为每千人注册护士数,公平性相对较差。结论整体上,江苏省卫生资源配置存在区域差异性与不公平性,苏南地区卫生资源配置水平较高,需关注医疗机构和护理人力资源的配置均衡性,地区内部不公平性问题较明显。因此,应优化全省各地区卫生资源发展规划,加强医疗机构与护理人力资源建设,重点关注地区内部卫生资源配置不公平性,缩小区域发展差距。

Objective To explore the characteristics and equity of regional allocation of health care resources in Jiangsu Province,aiming to further optimize the allocation.Methods Five indicators in two aspects(medical service facilities and health human resources)were selected to analyze the efficiency and equity of health care resource allocation in Jiangsu Province using the entropy-weight TOPSIS model and Theil index.Results According to the entropy-weighted TOPSIS method,among 13 cities in Jiangsu Province,Nanjing had the highest comprehensive evaluation score of health care resource allocation(C_(i) 0.654)and Zhenjiang had the lowest(C_(i) 0.153).Among the three major regions(Southern,Central,and Northern),the Sourthern Jiangsu had the highest comprehensive evaluation score(C_(i) 0.577).Among the five indicators,the number of registered nurses per 1,000 people had the highest Theil index,contributed most to inequity.Conclusions Generally,there are regional differences and inequities in the allocation of health care resources in Jiangsu Province,with Southern Jiangsu having the highest efficiency of health care resource allocation.Efforts should be made to promote the balanced allocation of medical institutions and nursing human resources.Inequity within each region is prominent.Therefore,it is important to optimize the developmental planning of health care resources in all regions of Jiangsu Province,strengthen the capacity-building of medical institutions and nursing human resources.Special attention should be paid to resolving the inequitable allocation of health care resources within regions and narrowing the regional developmental gaps.