2015-2019年间中国精神科医疗服务利用的公平性分析  

Analysis on the Equity of Mental Health Medical Services Utilization in China from 2015 to 2019

作　　者：孙思伟 云青萍 孙艳坤 常春[2] SUN Siwei(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing,100191,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100191 [2]北京大学公共卫生学院社会医学与健康教育系,北京100191

出　　处：《医学与社会》2022年第9期48-53,共6页Medicine and Society

摘　　要：目的:分析中国精神科医疗服务利用的公平性情况,提出卫生服务利用和提供方面的政策建议。方法:利用《中国卫生健康统计年鉴》等一系列公开数据,使用集中指数和集中曲线分析中国精神科医疗服务利用的公平性,采用Stata 16.0进行了数据分析和集中曲线的绘制。结果:本研究分析了精神科门急诊人次和出院人次的公平性情况,基于经济水平排序的精神科门急诊人次的集中指数由2015年的0.296下降到2019年的0.233;基于人口数量的集中指数由0.044下降到0.018;而基于地理面积的集中指数由-0.244上升至-0.189。基于经济水平排序的精神科出院人次的集中指数由2015年的0.040下降到2019年的-0.001,基于人口数量的集中指数由0.122下降到0.108,而基于地理面积的集中指数逐渐接近绝对公平水平。结论:2015-2019年间中国精神科医疗服务利用在经济维度上的公平性较差,中国精神科医疗服务的公平性状况有了很大的提升,呈现逐年改善的趋势,但较其他卫生服务利用的公平性差,需要加大精神卫生资源配置和服务提供的支持力度。Objective:To analyze the fairness of the utilization of psychiatric medical services in China,so as to put forward policy recommendations on the utilization and provision of health services.Methods:A series of public data,such as China health statistical yearbook were used,the concentration index(CI)and concentration curve were adopted to analyze the equity of mental health service utilization in China.In this study,Stata 16.0 was used for data analysis and concentration curve drawing.Results:In terms of outpatient and emergency visits in psychiatric outpatient services,the CI based on economic level decreased from 0.296 in 2015 to 0.233 in 2019,the CI based on population decreased from 0.044 to 0.018,and the CI based on geographical area increased from-0.244 to-0.189.While,the CI of number of discharges from psychiatric ward based on economic level decreased from 0.040 in 2015 to-0.001 in 2019,the CI based on population decreased from 0.122 to 0.108,and the CI based on geographical area gradually approached the absolute fair level.Conclusion:China’s mental health medical service utilization have been greatly improved.Mental health medical service utilization are unfair,showing a trend of improvement year by year,but they are less equitable than other health service resource allocation and service utilization.This study suggests that we should strengthen the support of mental health service system.

关 键 词：精神卫生 公平性 医疗服务 服务利用 

分 类 号：R195[医药卫生—卫生统计学]