2015—2019年我国31个省市中医类卫生资源配置现状与公平性研究

Current situation and equity of health resource allocation for Chinese Medicine in 31 provinces and cities from 2015 to 2019

目的分析2015—2019年我国中医类卫生资源配置现状及公平性,为进一步优化我国中医类卫生资源配置,促进中医药事业健康均衡发展提供参考依据。方法基于2015—2019年我国不含港澳台地区的31个省市自治区中医类卫生资源相关数据,运用Excel软件对我国中医类卫生资源配置情况进行描述性统计,计算基尼系数和集中指数,从人口、地理面积和GDP 3个维度进行公平性分析。结果2015—2019年我国按人口和GDP配置的中医类卫生资源基尼系数均在0.1~0.2左右,按占地面积配置的基尼系数除中医机构数外均大于0.4。中医类卫生资源集中指数在-0.0484~0.0811之间,总体公平性较好。2019年中医类机构和实有床位的集中指数分别为-0.0484和-0.0229,中医卫生技术人员、中医执业(助理)医师和中医财政补助收入的集中指数分别为0.0365、0.0524和0.0443。2015—2019年中医类机构和实有床位的集中指数均<0,中医卫生技术人员、中医执业(助理)医师和中医财政补助收入的集中指数均>0。结论我国中医类卫生资源配置整体公平性较好,但仍存在地区性不均衡现象,应进一步完善中医药人才机制和财政补助机制,合理规划床位规模,加强效益管理,促进中医药事业健康均衡发展。

Objective To analyze the current situation and fairness of China’s traditional Chinese Medicine(TCM)health resource allocation in China from 2015 to 2019,so as to provide reference for further optimizing TCM health resource allocation in China and promote the healthy and balanced development of TCM.Methods Descriptive statistics were performed on the data related to TCM health resources in 31 provinces,municipalities and autonomous regions in China from 2015to 2019.We calculated Gini coefficient and concentration index,and analyzed the fairness from the three dimensions of population,geographical area and GDP.Results In 2015 to 2019,the Gini coefficient of TCM health resources allocated by population and GDP in China ranged from 0.1 to0.2,and the Gini coefficient configured by geographical area was greater than 0.4 except for the number of TCM institutions.The concentration index of TCM health resources is between-0.0484and 0.0811,and the overall fairness is good.In 2019,the concentration index of TCM institutions and beds was-0.0484 and-0.0229,respectively.The concentration index of TCM technicians,practicing(assistant)physicians and TCM financial subsidy income is 0.0365,0.0524 and 0.0443,respectively.In 2015-2019,the concentration index of TCM institutions and actual beds is<0,and the concentration index of TCM health technicians,TCM practitioners(assistants)physicians and TCM financial subsidy income is all>0.Conclusions The overall fairness of the allocation of TCM health resources in China is good,but there is still a regional imbalance,and the TCM talent mechanism and financial subsidy mechanism should be further improved.The scale of beds should be rationally planned,the benefit management should be strengthened,and the healthy and balanced development of the TCM cause should be promoted.