2018-2021年我国疾病预防控制中心卫生资源配置现状和公平性分析

Current situation and equity analysis of center for disease control and prevention health resources allocation in China from 2018 to 2021

目的 分析2018-2021年我国疾病预防控制中心(以下简称疾控中心)卫生资源配置的现状和公平性,为合理配置卫生资源提供参考。方法 我国疾控中心机构数量、卫生技术人员数量和结构、各行政区域的人口数来源于2019-2022年《中国卫生健康统计年鉴》;各行政区域地理面积来自全国行政区划信息查询平台。东部、中部、西部划分依据为2022年《中国卫生健康统计年鉴》。采用Excel 2010软件统计数据,采用构成比、增长率等描述我国不同地区疾控中心的卫生资源配置现状,采用基尼系数和泰尔指数分析我国不同地区疾控中心的卫生资源配置公平性。结果 2018-2021年全国和中部、西部疾控中心机构数量减少,只有东部地区波动增长。2018-2021年全国和东部、中部、西部疾控中心卫生技术人员均呈增长趋势。2021年疾控中心卫生技术人员以工作30年及以上者最多;学历以大学本科和专科为主;高级专业技术资格的人员仅占16%。疾控中心机构数2018-2021年按人口配置的基尼系数主要集中在0.2~0.3,总泰尔指数在0.06左右;按地理面积配置的基尼系数接近0.5,总泰尔指数在0.17左右。疾控中心卫生技术人员2018-2021年按人口配置的基尼系数均<0.2,总泰尔指数均<0.03;按地理面积配置的基尼系数主要集中在0.5~0.6,总泰尔指数在0.25左右。结论 2018-2021年我国疾控中心机构数持续减少,卫生技术人员先减后增,职称、学历、年龄结构有所优化但仍需完善。疾控中心卫生技术人员和机构数按人口配置的公平性优于按地理面积配置的公平性,按人口配置的不公平主要来自区域内;按地理面积配置的不公平主要来自区域间。

Objective To analyze the current situation and equity of center for disease control and prevention(hereinafter referred to as CDC)health resources allocation in China from 2018 to 2021,so as to provide reference for the rational allocation of health resources.Methods The number of institutions of CDC,the number and structure of health technicians,and the population of each administrative region were sourced from the 2019-2022 China Health Statistical Yearbook;The geographical area of each administrative region came from the National Administrative Division Information Query Platform.The division of eastern,central,and western regions was based on the 2022 China Health Statistics Yearbook.Excel 2010 software was used to analyze data,the composition ratios and growth rates were used to describe the current status of health resource allocation at CDCs in different regions of the country,and Gini coefficient and Theil index were used to analyze the equity of health resource allocation.Results From 2018 to 2021,the number of national,central,and western disease control centers decreased,with only the eastern region experiencing fluctuating growth.From 2018 to 2021,the number of health technicians in China,as well as in the eastern,central,and western regions,showed a growing trend.In 2021,the highest number of health technicians from CDC was who have worked for 30 years or more;Education was predominantly undergraduate and associate degrees;Only 16%of personnel had advanced professional and technical qualifications.The number of CDC from 2018 to 2021 was mainly concentrated in the Gini coefficient of 0.2-0.3 according to population allocation,with a total Theil index of around 0.06;The Gini coefficient configured by geographical area was close to 0.5,and the total Theil index was around 0.17.From 2018 to 2021,the Gini coefficient of health technicians according to population allocation was less than 0.2,and the total Theil index was less than 0.03;The Gini coefficient configured by geographical area was mainly concentrated between 0.5 and 0.6,and the total Theil index was around 0.25.Conclusion From 2018 to 2021,the number of CDC in China continued to decrease,with a decrease followed by an increase in health technicians.The structure of professional titles,educational qualifications,and age has been optimized,but still needs to be improved.The equity of population allocation for health technicians and institutions is better than that of geographical area allocation,and the unfairness of population allocation mainly comes from within the region;The unfairness of geographical area allocation mainly comes from inter regional differences.