2012-2014年上海市嘉定区主要医疗卫生资源配置公平性分析

目的 研究2012-2014年上海市嘉定区卫生资源配置的现况,评价其配置公平性.方法 采用基尼系数分别从人口分布和地理分布比较2012-2014年嘉定区主要卫生资源配置.结果 2012-2014年每千人口床位、医师、护士的配置总量逐年增加,分别达到2.52,1.42,1.61;2012-2014年按人口分布的主要卫生资源基尼系数也有调整,变化较大的是床位,从2012年的0.42下降到2014年的0.39,护士的基尼系数一直维持在0.41～0.42的水平,而医师的基尼系数呈现上升趋势,从2012年0.30上升到2014年的0.36;2012-2014年卫生资源按地理面积分布的基尼系数高于按人口分布的基尼系数,按地理分布的床位、医生、护士基尼系数均呈上升趋势,医生的基尼系数小于0.4,但床位及护士基尼系数超过警戒线,维持在0.44～0.48之间.结论 嘉定区主要卫生资源总量不足且分布不均衡,政府在加大卫生资源投入的同时应考虑均衡性,投入应向远郊地区倾斜.

Analysis of the Equity of the Main Health Resources Allocation in Jiading District of Shanghai City from 2012 to 2014

Objectives To study the current situation of health resource allocation of Jiading district of Shanghai from 2012 to 2014,and to evaluate the fairness of the allocation.Methods Gini coefficient was applied to evaluate the distribution equity of population and geography area of community health resources from 2012 to 2014.Results During 2012 and 2014,The average per thousand population of hospital beds,physicians and nurses increased year by year,reaching 2.52,1.42 and 1.61,respectively.As to the population distribution,the Gini coefficient of hospital beds had down from 0.42 in 2012 to 0.39 in 2014.The Gini coefficient of nurses maintained at the level of 0.41 ~ 0.42,and the physician's Gini coefficient had a rising trend,increasing from 0.30 in 2012 to 0.36 in 2014.From 2012 to 2014,the Gini coefficient of health resources according to geographical area distribution was higher than the Gini coefficient of population distribution.As to the geographical distribution of beds,doctors,nurses,the Gini coefficients showed an upward trend.The doctor's Gini coefficient was less than 0.4,while the beds and nurses' Gini coefficients exceed cordon,which maintained between 0.44~0.48. Conclusions The main health resources is insufficient and uneven distributed in Jiading district.Government should take the balance into account in increasing health resource investment,and the investment should be tilted to the suburban areas.