基于基尼系数、洛伦兹曲线和聚集度的我国卒中中心配置公平性分析  

Analysis of the Fairness of the Configuration of Stroke Center in China Based on the Gini Coefficient,Lorenz Curve and Agglomeration

作　　者：张佳雯 郑英[2,3] 胡佳[2,3] 代涛 Zhang Jiawen;Zheng Ying;Hu Jia(Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing,100010,China;不详)

机构地区：[1]中国医学科学院北京协和医学院,北京100010 [2]中国医学科学院医学信息研究所,北京100020 [3]中国医学科学院卫生政策与管理研究中心,北京100020

出　　处：《中国医院管理》2024年第11期40-44,共5页Chinese Hospital Management

摘　　要：目的评价我国卒中中心的配置公平性,为进一步规范和提高卒中患者的救治水平、保证医疗质量与安全提供参考依据。方法运用基尼系数、集聚度和洛伦兹曲线对当前我国卒中中心的配置公平性进行衡量。通过地理信息系统技术进行空间信息分析和处理,将视觉化效果和地理分析功能结合,发现其分布的空间差异。结果目前,我国卒中中心有1414家。34个省级行政区中,卒中中心配置按人口分布的洛伦兹曲线均位于公平线之下,各省级行政区的基尼系数和洛伦兹曲线显示出各地资源配置不公平性差距较大,超过半数的省级行政区卒中中心的卫生资源集聚度/人口集聚度<1,卒中中心分布相对于集聚人口不足。我国卒中中心的最近邻指数为0.58,属于典型的聚集模式,分区差异有统计学意义(P<0.01)。结论我国卒中中心规划已见成效,但仍需持续推进与建设。应针对人口公平性优于地理公平性的现状,结合城市规划优化调整,因地制宜、宣教先行,以应对不同省级行政区配置公平性的明显差异。Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD<1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P<0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

关 键 词：卒中中心 公平性 基尼系数 洛伦兹曲线 集聚度 地理信息系统 

分 类 号：R197.323.2[医药卫生—卫生事业管理]