我国全科医生资源配置与公平性研究  

Studying on The Equity of Resource Allocation of General Practitioners in China

作　　者：秘玉清 张继萍 刘一鋆 于慧慧[1] 殷延玲 董宇[1] 罗盛[1] 李伟[1] BI Yu-qing(School of Public Health and Management,Weifang Medical University,Weifang,P.R.China)

机构地区：[1]潍坊医学院公共卫生与管理学院,山东潍坊261053 [2]潍坊医学院护理学院

出　　处：《中国卫生事业管理》2019年第9期661-663,701,共4页Chinese Health Service Management

基　　金：国家自然科学基金“整体健康管理视角下老年社区慢性病管理系统脆弱性分析及管理策略研究—以山东省为例”(71774119);国家自然科学基金“健康管理视角下中国城市老年社区护理服务适宜项目及管理策略研究—以山东省为例”(71373181);2017年全国统计科学研究项目“健康老龄化视角下农村老年慢性病风险评价与预警研究—一山东省为例”(2017LY40);山东省高等医学教育“应用型卫生管理专业人才培养模式研究—职业岗位需求理论下”(YJKT201708);山东省社会科学规划研究项目“健康中国视域下我国农村社区养老服务体系脆弱性分析及优化管理策略研究”(18CGLJ51)

摘　　要：目的:了解我国全科医生资源配置现状,分析全科医生配置公平性,为科学管理我国全科医生资源提供合理依据。方法:运用洛伦兹曲线、基尼系数和泰尔指数对2013-2015年我国全科医生资源配置的人口、经济和地理公平性进行评价分析。结果:2015年,我国全科医生总数为188649人,较2014年增长9.30%,较2013年增长29.65%;全科医生总数占执业(助理)医师的比重为6.21%;每万人口全科医生数为1.37人,东部地区配比最高,为1.83人。2013.2015年,基尼系数(人口)分别为0.2124.0.0924.0.1699,基尼系数(生产总值)分别为0.2175.0.1769.0.0907,基尼系数(面积)分别为0.5093.0.5624.0.5453;人口维度的泰尔指数由0.0609降到0.0465,经济维度的泰尔指数由0.0328降到0.0280,地理维度的泰尔指数由0.5617降到0.4489o人口和经济维度的配置不公平性主要来源于组内差异,组内差异主要源于东部地区;地理维度的配置不公平性主要来源于组间差异。结论:我国全科医生配置总量持续增长,但人口配比仍显不足。地区配置存在差异,人口和经济维度的配置公平性优于地理维度。Objective To explore the status and fairness of allocation of general practitioners in China, and provide reasonable basis for scientific management on it. Methods The population, economic and geographical fairness of allocation of general practitioners from 2013 to 2015 in China was analyzed with Lorentz curve, Gini coefficient and Thiel index. Results The total amount of general practitioners was 188 ,649 in China in 2015, increased by 9. 30% compared with that in 2014, and increased by 29. 65% compared with that in 2013. The number of general practitioners accounted for 6. 21% of the totaled registered physicians. There had 1. 37 general practitioners per 10,000 population, the highest of which was in eastern region. From 2013 to 2015 , the Gini coefficient ( population) was 0.2124, 0. 0924 and 0. 1699, respectively;the Gini coefficient ( gross product) was 0.2175, 0. 1769 and 0. 0907 , respectively;and the Gini coefficient ( area) was 0. 5093, 0. 5624 and 0. 5453 , respectively. The Thiel index of population dimension decreased from 0. 0609 to 0. 0465. The Thiel index of economic dimension decreased from 0. 0328 to 0. 0280. And the Thiel index of geographical dimension decreased from 0. 5617 to 0. 4489. The unfairness of population and economic dimensions was mainly derived from intra - group differences, which was mainly from the eastern region. The unfairness of geographical dimension was mainly derived from the differences between groups. Conclusion The total number of general practitioners in China kept increasing, but the overall distribution was unsatisfied. Regional allocation was different. And the allocation of population and economic dimensions was better than geographical dimension.

关 键 词：全科医生 资源配置 公平性 洛伦兹曲线 基尼系数 泰尔指数 

分 类 号：R192.3[医药卫生—卫生事业管理]