中部A省大型医用设备配置公平性评价  

Equity of allocating large scale medical equipment in a central province

作　　者：何露洋[1] 陈英耀[1] 黄晓玲[1] 刘静[1] 魏艳[1] HE Lu-yang CHEN Ying-yao HUANG Xiao-ling LIU Jing WEI Yan(School of Public Health, Fudan University/Key Lab of Health Technology Assessment, Ministry of Health, Shanghai 200032, China)

机构地区：[1]复旦大学公共卫生学院/卫生部卫生技术评估重点实验室,上海200032

出　　处：《中国卫生资源》2017年第4期300-303,共4页Chinese Health Resources

基　　金：美国中华医学基金会(CMB)"中国卫生技术评估合作项目"(13-153);上海市第四轮公共卫生三年行动计划重点学科建设项目循证公共卫生与卫生经济学(15GWZK0901)

摘　　要：目的 :对大型医用设备配置许可证政策实施后的A省大型医用设备配置公平性进行评价,并对优化大型医用设备配置管理提出政策建议。方法:采用基尼系数、泰尔指数和集中指数评价A省计算机断层扫描(CT)、磁共振成像(MRI)配置的公平性和变化趋势,并通过泰尔指数分解和集中指数分析经济因素对公平性的影响。结果:2005—2013年,CT和MRI的按人口配置的基尼系数、MRI按地理配置的基尼系数、CT和MRI的泰尔指数和MRI集中指数均呈下降趋势,CT按地理配置的基尼系数和集中指数略微上升。2005—2013年CT和MRI的泰尔指数分解显示,组内差异对泰尔指数贡献率基本保持在80%以上。结论 :大型医用设备配置管理政策的实施促进了A省基于人口的CT、MRI的配置公平性,但基于地理的CT配置公平性有所降低;区域内差异是造成A省CT设备配置不公平性的主要原因,而经济因素对CT、MRI配置公平性的影响不大。Objective： To evaluate the equity of allocating large scale medical equipment in one central province after the implementation of certificate of need （ CON ） policy on large scale medical equipment, and to provide suggestions for optimizing the management policy. Methods： Gini coefficient, Theil index and concentration index were used to evaluate the equity and the trends of allocating CT and MRI. The impact of economic factors on equity was analyzed by the decomposition of Theil index and concentration index. Results： Population-based C, ini coefficient of CT and MRI, geography-based Gini coefficient of MRI, Theil index of CT and MRI, and concentration index of MRI all showed a downward trend, while geography-based Gini coefficient and concentration index of CT increased slightly. The decomposition of Theil index of CT and MRI from 2005 to 2008 demonstrated that the contribution of the intergroup differences to Theil index stayed above 80%. Conclusion ： The implementation of CON policy facilitated the equity of the population-based distribution of CT and MR1. However, the equity of the geography-based distribution of CT declined. The differences of intergroup is the main reason of the inequity of allocating CT and MRI, while the effect of economic factors on the equity is not significant.

关 键 词：大型医用设备 计算机断层扫描 磁共振成像 公平性 基尼系数 泰尔指数 集中指数 

分 类 号：R197-39[医药卫生—卫生事业管理]