天津市中医医疗资源配置状况及公平性研究

Research on the status and equity of traditional Chinese medicine medical resource allocation in Tianjin

目的分析2011—2020年天津市中医医疗资源配置发展状况及其公平性,为天津中医药卫生事业发展提供建议。方法从2011—2020年《天津市卫生健康统计资料》中获取同期天津市中医医院、医院床位和医院卫生技术人员配置数据,采用描述分析方法评价天津市中医医疗资源配置整体状况,利用基尼系数与差别指数评价天津中医医疗资源配置公平性。结果2011—2020年,天津市中医医疗资源总量和每千人口拥有量均有较大增长,三类资源涨幅均超过50%。除个别年份的个别指标外,按人口、地理和国内生产总值(GDP)配置的基尼系数均>0.4;按地理计算的差别指数均>0.5,按人口计算的差别指数均<0.5,按GDP计算的差别指数为0.4~0.6。除按人口计算的床位差别指数从0.40减少至0.39外,按人口、地理配置的基尼系数和差别指数均有增大,机构配置的基尼系数和差别指数上升幅度均超过30%,资源配置公平性下降;按GDP配置的基尼系数和差别指数均有3%~12%的减小,资源配置公平性提高。结论应转变中医医疗资源管理方式,加强偏远和农村地区资源配置,控制中医医院在经济发达地区的扩张,实现优质中医医疗资源扩容和区域均衡布局。

Objective To analyze the development status and equity of traditional Chinese medicine medical resources allocation in Tianjin from 2011 to 2020,and to provide suggestions for the development of traditional Chinese medicine health undertakings in Tianjin.Methods Data on the allocation of traditional Chinese medicine hospitals,hospital beds,and health technicians in Tianjin during 2011—2020 were obtained from Tianjin Health Statistics.Descriptive analysis method was used to analyze the overall situation of traditional Chinese medicine medical resource allocation in Tianjin,and Gini coefficient and difference index were used to evaluate the fairness of traditional Chinese medicine medical resource allocation in Tianjin.Results During 2011—2020,the total amount of traditional Chinese medicine medical resources and the possession of each thousand population in Tianjin had increased greatly,and the three types of resources had increased by more than 50%.The Gini coefficients of population,geography and gross domestic product(GDP)were all>0.4,except for some indicators in some years.The difference index calculated by geography was>0.5,the difference index calculated by population was<0.5,and the difference index calculated by GDP was 0.4-0.6.The Gini coefficient and the difference index of beds by population decreased from 0.40 to 0.39,but the Gini coefficient and difference index of beds by population and geographical allocation increased,and the Gini coefficient and difference index of institutional allocation increased by more than 30%,while the equity of resource allocation decreased.The Gini coefficient and difference index of GDP allocation decreased by 3%-12%,and the fairness of resource allocation increased.Conclusion We should change the management mode of traditional Chinese medicine medical resources,strengthen the allocation of resources in remote and rural areas,control the expansion of traditional Chinese medicine hospitals in economically developed areas,and achieve the expansion of high-quality traditional Chinese medicine medical resources and a balanced regional layout.