2018年河南省妇幼保健机构卫生资源配置公平性分析

Research on the equity of health resources allocation in maternal and child health institutions in Henan province in 2018

目的 了解目前河南省妇幼保健机构卫生资源配置的现状,为卫生资源配置提供依据。方法 对2018年河南省妇幼保健机构卫生资源配置进行描述性分析,并采用卫生资源集聚度(HRAD)以及HRAD与人口集聚度(PAD)的比值评价卫生资源配置的公平性。结果 2018年河南省全省各地市间医疗机构数、床位数及卫生技术人员数分布不均。卫生技术人员的职称分布中正高、副高、中级、初级、其他的比例约为1∶4∶19∶44∶8;学历分布以大专及以下学历为主(49.2%),其次为本科学历(43.9%),研究生学历最少(3.8%)。郑州、漯河、焦作的医疗机构、编制床位及卫生技术人员的HRAD远大于1;南阳、信阳、三门峡、济源、洛阳、新乡、周口、驻马店、许昌和商丘地区的医疗机构、编制床位及卫生技术人员的HRAD部分小于1。从HRAD/PAD来看,商丘、周口、南阳集聚的医疗机构数按人口配置公平性较差;洛阳、周口的编制床位数按人口配置公平性较差;洛阳、周口、新乡、南阳、驻马店的卫生技术人员按人口配置公平性较差。结论 河南省妇幼保健机构卫生技术人员整体质量偏低,全省卫生资源配置地理可及性整体较好,但仍有部分地区资源配置不足。政府应综合考虑人口和地理等因素,为妇幼保健机构提供人才支持政策,提高河南省妇幼保健机构卫生资源配置的公平性。

Objective To analyze the equity of health resources allocation in maternal and child health institutions in Henan province,and to provide scientific basis for health resources allocation. Methods The statistical description was based on the overall data of health resources allocation in maternal and child health institutions in Henan province.Health resources agglomeration degree(HRAD) and the ratio of HARD to population agglomeration degree(PAD) were used to evaluate the equity of health resources allocation. Results The distribution of number of institutions,hospital beds,and personnel from different cities and areas in Henan province was not equal.The proportion of people with senior title, vice-senior title, middle title, primary title and others was about 1∶4∶19∶44∶8;the proportion of college degree or below, bachelor’s degree, master’s degree or above was respectively 49.2%,43.9%,3.8%.HRAD of medical institutions, established beds and health technicians was significantly greater than 1 in Zhengzhou, Luohe and Jiaozuo. In Nanyang, Xinyang, Sanmenxia, Jiyuan, Luoyang, Xinxiang, Zhoukou, Zhumadian,Xuchang and Shangqiu, the HRAD of medical institutions, established beds and health technicians was partially less than 1.The ratio of HRAD/PAD showed that according to the population allocation, the number of medical institutions had poor equity in Shangqiu, Zhoukou and Nanyang, the number of established beds had poor equity in Luoyang and Zhoukou,and the health technicians had poor equity in Luoyang, Zhoukou, Xinxiang, Nanyang and Zhumadian. Conclusion In maternal and child health care institutions in Henan province, the quality of health technicians is low, and the geographical accessibility of health resources allocation is good overall, but there was still insufficient resources allocation in some areas.To improve the fairness of health resources allocation in Henan province, the government should take population and geographical factors into health resources allocation,and provide talent support policies to maternal and child health institutions.