我国专业公共卫生机构卫生资源公平性分析

Analysis of health resources equity in Chinese specialized public health institutions

目的分析我国专业公共卫生机构卫生资源配置公平性,为进一步优化公共卫生资源配置提供参考依据。方法采用基尼系数、泰尔指数、集聚度和雷达图曲线,分析2016—2020年我国专业公共卫生机构卫生资源配置公平性。结果2016—2020年,我国专业公共卫生机构数、床位、卫生人员、执业(助理)医师和财政补助收入年均增速分别为-12.63%、4.61%、1.82%、2.35%和14.31%。西部地区床位、卫生人员和执业(助理)医师年均增速较高,中部财政补助收入年均增速较高。按人口配置的基尼系数为0.2~0.3,泰尔指数为0.0066~0.0644,整体公平性较好。区域内贡献率>区域间贡献率,各区域内卫生资源配置差异显著。2020年东部地区卫生资源集聚度均>1,西部地区均<1,但中、西部地区各类公共卫生资源差值均>0,东部地区均<0。GDP发展水平与公共卫生机构财政补助收入呈正向相关关系。结论我国公共卫生机构卫生资源配置整体公平性较好,但仍存在地区性差异,应因地制宜的针对性调整公共卫生机构卫生资源配置措施,注重改善区域内公平性,进一步提高公共卫生机构财政补助收入效益,加强地方政府的可持续性投入和重视程度。

Objective This study aims to analyze the fairness of health resource allocation in specialized public health institutions in China and provide a reference for further optimizing the allocation of public health resources.Methods The equity of the health resource allocation of specialized public health institutions in China from 2016 to 2020 was analyzed using the Gini coeficient,Thiel index,agglomeration,and radar chart curve.Results From 2016 to 2020,the average annual growth rates of the number of specialized public health institutions,beds,health personnel,practicing(assistant)physicians,and fiscal subsidies in China were-12.63%,4.61%,1.82%,2.35%,and 14.31%respectively.The western region had higher average annual growth rates for beds,health personnel,and practicing(assistant)physicians,while the central region had higher average annual growth rates for fiscal subsidies.The Gini coefficient for population-based allocation was 0.2-0.3,and the Thiel index was between 0.0066 and 0.0644,indicating overall good equity.The contribution rate within regions was greater than that between regions,and the allocation of health resources varies significantly.In 2020,the agglomeration of health resources in the eastern regions was greater than 1,and the agglomeration in the westem regions was less than 1.However,the difference of public health resources in the central and western regions was greater than O,and the eastern regions were less than O.The development level of GDP was positively correlated to the financial subsidy income of public health institutions.Conclusions Public health institutions'health resource allocation is fair overall,but regional differences remain.Therefore,targeted adjustments should be made to the allocation of public health institutions'health resources in diferent regions,paying attention to improving regional fairness,further improving the public health institutions'financial subsidies,and strengthening the sustainability of investment and emphasis of local governments.