“十二五”末期我国医疗卫生资源配置的公平性及效率研究  

Study on the configuration fairness and the efficiency of health resource in China at the end of the “twelfth five-year”

作　　者：郝义彬[1] 裴青燕 鲁锋 付先知 王璐[1] 连祎晓 孙长青[1] HAO Yi-bin PEI Qing-yan LU Feng FU Xian-zhi WANG Lu LIAN Yi-xiao SUN Chang-qing(College of Public Health,Zhengzhou University,Zhengzhou Henan 450001,China Department of Medical Equipment Management, The Second Afliated Hospital of Zhengzhou University, Zhengzhou Henan 450003,China） .)

机构地区：[1]郑州大学公共卫生学院,河南郑州450001 [2]郑州大学第二附属医院医学装备管理科,河南郑州450003

出　　处：《中国卫生资源》2017年第6期511-515,共5页Chinese Health Resources

基　　金：国家社会科学基金(15BSH043)

摘　　要：目的 :分析"十二五"末期我国医疗卫生资源配置的公平性和效率,为我国"十三五"期间医疗卫生资源配置提供参考依据。方法 :使用基尼系数、泰尔指数进行公平性分析;使用数据包络分析进行效率分析。结果:我国31个省级行政区(不含我国港、澳、台地区数据)的医疗卫生机构数、医疗卫生机构床位数、医疗卫生人员数和医疗卫生总支出按人口分布的基尼系数均小于0.3,公平性较好;泰尔指数的结果为组内差异大于组间差异,说明卫生资源配置相对的不公平更多是由东部、中部和西部的区域内差异造成的。我国31个省级行政区中,11个省级行政区的医疗卫生资源利用效率属于非DEA有效,这些省级行政区的医疗卫生机构和医疗卫生机构总支出紧缺。结论:"十二五"末期我国医疗卫生资源配置相对公平,4项指标中医疗卫生机构总支出的公平性最差,相对的不公平可能是东部、中部和西部区域内部的差异造成的。医疗卫生资源配置效率需进一步提高,医疗卫生机构总支出分配公平性不足,影响了各省的医疗卫生资源的配置效率。ObjectiveTo analyze the equity and efficiency of health resource allocation in China,and to support reference for the allocation of health resource during the “thirteenth five-year”. Methods ：Gini coefficient and Theil index were calculated to analyze the equity of health resource allocation. Data envelopment analysis（DEA） was conducted for efficiency analysis. Results ：According to the population distribution,the Gini coefficient of the number of health institutions,hospital beds,health professionals,and total health expenditure in 31 Chinese provincial regions（data of Hong Kong,Macao and Taiwan were not included） were less than 0.3,which reflected a good allocation of health resource. The result of Theil index showed that difference within groups was greater than difference between groups,indicating that the inequity of health resource allocation was mainly caused by internal difference of eastern,central and western regions of China. Among 31 provinces,the utilization efficiency of health resource in 11 provinces was non DEA efficient. The number of health institutions and its total health expenditure were insufficient. Conclusion ：At the end of the “twelfth five-year”,the health resource allocation in China was relatively fair. Among the four indicators,the most unequal was observed in the total expenditure of health institutions. This unfairness was probably caused by internal difference of regions. It is suggested that the efficiency of health institutions be further improved. The inadequate configuration fairness of total expenditure in health institutions affects the utilization efficiency of health resource on the provincial level.

关 键 词：医疗卫生资源 公平 效率 基尼系数 泰尔指数 数据包络分析 

分 类 号：R1-9[医药卫生—公共卫生与预防医学]