我国卫生资源配置的公平性研究  

Fairness of health resource allocation,China

作　　者：王啸宇 王芊芊 徐景菊 刘玉琢 薛梓晨 徐超 陈彤 陈倩 黄静雯 李伟[2] WANG Xiao-yu;WANG Qian-qian;XU Jing-ju;LIU Yu-zhuo;XUE Zi-chen;XU Chao;CHEN Tong;CHEN Qian;HUANG Jing-wen;LI Wei(School of Management,Weifang Medical University,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院管理学院,山东261053 [2]潍坊医学院公共卫生学院 [3]潍坊医学院护理学院

出　　处：《现代预防医学》2022年第5期845-850,共6页Modern Preventive Medicine

基　　金：国家自然科学基金项目(71774119);教育部人文社会科学研究青年基金项目(18YJCZH118);山东省自然科学基金资助项目(ZR2019MG027);全国统计科学研究项目(2020LY044)。

摘　　要：目的分析我国东部、中部、西部(31个省、直辖市、自治区)目前的卫生资源配置情况,为我国新阶段"十四五规划"中优化卫生资源的分配的目标提供现实依据。方法通过查阅《中国卫生健康统计年鉴》(2020)中相关数据资料,采用洛伦兹曲线、基尼系数和泰尔指数三个指标对我国2019年执业(助理)医师、护士、床位和医疗机构按人口和地理配置的公平性进行评价。结果可以明显看出按人口配置的洛伦兹曲线的弯曲程度小于按地理配置的弯曲程度。2019年我国执业(助理)医师、注册护士、床位、医疗机构按人口配置的基尼系数分别是0.084、0.093、0.077和0.213,按地理配置的基尼系数分别是0.617、0.610、0.556和0.434。执业(助理)医师、注册护士、床位以及医疗机构的泰尔指数组间贡献率分别是36.0%、35.6%、28.1%和23.0%;组内贡献率分别是64.0%、64.4%、71.9%和77.0%。东部地区执业(助理)医师、注册护士、床位、医疗机构的泰尔指数贡献率均最高。结论我国医疗卫生资源配置存在不公平现象,各项卫生资源按地理面积配置远劣于按人口配置。影响我国各项卫生资源配置公平性的主要因素是各区域内部的不公平性。Objective To analyze the current allocation of health resources in eastern,central and western China(31 provinces,municipalities directly under the central government and autonomous regions),and to provide a realistic basis for the goal of optimizing the allocation of health resources in the 14 th Five-Year Plan of China.Methods The fairness of practicing(assistant)doctors,nurses,beds and medical institutions in China in 2019 was evaluated according to population and geographical allocation by Lorenz curve,Gini coefficient and Theil index,referring to relevant data in China Health Statistical Yearbook(2020).Results The Lorenz curve of population configuration was less curved than that of geography configuration.In 2019,the Gini coefficients of practicing(assistant)doctors,registered nurses,beds and medical institutions in China were 0.084,0.093,0.077 and 0.213 by population,and 0.617,0.610,0.556 and 0.434 by geography,respectively.The inter-group contribution rates of Theil index of practicing(assistant)physicians,registered nurses,beds and medical institutions were 36.0%,35.6%,28.1%and 23.0%,respectively,and the intra-group contribution rates were 64.0%,64.4%,71.9%and 77.0%,respectively.Theil index contribution rates of practicing(assistant)doctors,registered nurses,beds and medical institutions were the highest in eastern China.Conclusion The allocation of medical and health resources in China is not fair.The allocation of health resources according to geographical area is much worse than that according to population.The main factor affecting the fairness of health resource allocation in China is the inequity within each region.

关 键 词：卫生资源配置 公平性 洛伦兹曲线 基尼系数 泰尔指数 

分 类 号：R197.1[医药卫生—卫生事业管理]