基于基尼系数和集中指数的我国中医药卫生资源配置公平性分析

Analysis on the Equity of Traditional Chinese Medicine Health Resources Allocation in China Based on Gini Coefficient and Concentration Index

目的:对我国中医药卫生资源配置的公平性进行分析,为卫生资源优化配置提供科学依据。方法:综合运用卫生资源密度指数、基尼系数、洛伦兹曲线、集中指数和集中曲线,从人口、经济和地理分布对我国中医药卫生资源的配置状况与公平性进行分析。结果:2015—2020年我国中医药卫生资源量总体呈上升趋势。各地区中医药卫生资源的密度指数分布与各地区每平方千米中医药卫生资源数的分布基本一致。按人口分布的基尼系数均小于0.3,处于最理想的状态;按经济分布的基尼系数在0.2~0.4之间,处于合理状态,集中指数均为正值;按地理面积分布的基尼系数大部分大于0.6,处于极度不公平状态。结论:2015—2020年我国中医药卫生资源总量的配置情况较好;2020年我国中医药卫生资源配置存在区域性差异,东部和中部地区配置公平性较好,西部地区较差;配置公平性的排序为:人口分布>经济分布>地理分布。应统筹考虑人口、经济和地理因素对中医药卫生资源配置的影响,缩小地区间中医药卫生资源配置的差距,进一步优化配置结构,提高卫生资源配置的公平性。

Objective:To analyze the equity of traditional Chinese medicine(TCM) health resources allocation in China,and to provide scientific basis for the optimal allocation of health resources.Methods:From the perspective of population,economy and geographical distribution,this paper used health resources density index(HRDI),Gini coefficient,Lorenz curve,concentration index and concentration curve to analyze the status and equity of TCM health resources allocation in China.Results:From 2015 to 2020,TCM health resources in China showed an increasing trend.The distribution of HRDI of TCM health resources in each region was basically consistent with the distribution of TCM health resources per square kilometer in each region.The Gini coefficient of population distribution was less than 0.3,which was in the optimal state.The Gini coefficient of economic distribution was between 0.2 to 0.4,which was in a reasonable state,and the concentration index was positive.The Gini coefficient distributed by geographical area was mostly greater than 0.6,which was extremely inequity.Conclusion:The total allocation of TCM health resources in China from 2015 to 2020 was good.In 2020,there were regional differences in the allocation of TCM health resources in China.The allocation of TCM health resources in eastern and central China was more equity,while that in western China was less equity.The order of distributive equity was:population distribution > economic distribution > geographical distribution.It is necessary to consider the influence of population,economy and geographical factors on the allocation of TCM health resources,narrow the gap between regions in the allocation of TCM health resources,and further optimize the allocation structure and improve the equity of the allocation of TCM health resources.