社区卫生服务资源配置评价方法研究

目的探讨深圳市区域社区卫生服务资源配置状况及其公平性程度,为社区卫生资源配置评价方法提供依据.方法对深圳六个区采取分层整群随机抽样的方法,在深圳市区内和市区外各抽取一个区.并用Lorenz曲线和Gini系数对深圳市区内外2城区90家社区卫生服务资源配置状况进行评价.结果在资源配置人均拥有量上市区内高于市区外;在资源配置公平程度上,2城区社区卫生卫技人员总数、社区医生数、机构设施数、市政府对社区卫生服务投入经费等资源在人口配置上其Gini系数处于0.2～0.4之间,其公平状态处于最佳状态和正常状态;而业务用房2区Gini系数＞0.4,均处于警戒状态;2城区社区护士数在人口配置上其Gini系数分别为0.423和0.302,即整体公平状态市区外好与市区内.结论在区域内社区卫生服务资源配置评价时,应将资源配置水平指标与公平性指标相结合,才能完整地评价社区卫生资源配置的实际状况.

Evaluation Method Studies on Equity of Resources Allocation for Community Health Services in Living Areas

Objective To obtain empirical study results in the evaluation for community health services resources allocation through the studies on the equity of resources allocation for community health services in both urban and rural areas of Shenzhen.Methods 90 organizations were randomly selected with cluster sampling in 2 areas (one urban and one rural) out of the total 6 areas of Shenzhen,these 2 chosen areas were evaluated by means of the Lorenz curve and Gini coefficient.Results The results of analysis showed that the urban area outdid the rural area in the average occupation of recourses;the Gini coefficients were between 0.2 and 0.4 in the aspects of the medical worker and doctor providing,organization and facility supply as well as government devoting outlay based on the local population distribution which indicate they were in a perfect or normal status;however,the Gini coefficient was over 0.4 in the organization acreage in the 2 areas,which was a danger status of inequity.The Gini coefficients were separately 0.423 and 0.302 for nurse numbers based on the local population distribution in the 2 areas,which means the rural area outdid the urban area.Conclusion In the evaluation of resources allocation of community health services of a living area,indexes of both the resources allocation level and equity level are to be considered,so as to fully evaluate on the actual situation of resources allocation for community health services.