Gini系数和泰尔指数在山东省妇幼保健卫生人力资源配置公平性中的应用研究

目的探讨山东省妇幼保健机构卫生人力资源配置公平性,为妇幼保健人员的合理配置提供决策依据。方法对山东省2015-2017年妇幼保健机构卫生人力资源现况开展问卷调查。综合运用卫生资源密度指数指标(HRDI)、基尼系数及泰尔指数等方法,分别从人口、地理两个维度分析卫生人力资源配置的公平性。结果2015-2017年,山东省妇幼保健机构卫生人力总量呈逐年上升趋势。各地市相比,3年间HRDI最高的均为枣庄市,最低的为滨州市,两市相差近6倍。东营市、滨州市和菏泽市的HRDI远低于全省平均水平。基于人口维度,山东省妇幼保健人力资源基尼系数3年间均维持在0.20左右。东部和西部地区的基尼系数均<0.20,中部地区的基尼系数0.20~0.30。泰尔指数组内差异贡献率均高于80%。基于地理面积维度,基尼系数3年间均维持在0.25左右,西部地区的基尼系数均<0.20,东、中部地区的基尼系数0.20~0.30。泰尔指数组内差异贡献率均高于90%。结论山东省妇幼保健机构卫生人力配置公平性总体较好,人口公平性优于地理面积公平性。在下一步配置中在考虑人口因素的同时,要兼顾地理面积因素。

The equity of human resource allocation in maternal and child health care centers in Shandong Province based on Gini coefficient and Theil index

Objective To explore the allocation equity of human resources on maternal and child health care in Shandong Province,aim at providing basic policy for allocation of maternal and child health care.Methods A questionnaire was conducted to explore current situation and trend of human resources on maternal and child health care in Shandong Province from 2015 to 2017.Health resource density index(HRDI),Gini Coefficient and Theil Index were used to analyze the equity of human resource with the two dimensions of population distribution and geographic configuration.Results The number of human resources on the maternal and child health care in Shandong Province was increasing from 2015 to 2017.Compared on HRDI,the highest is Zaozhuang City among 17 cities,and the lowest is Binzhou City.The difference between the two cities is nearly 6 times.The HRDI of Dongying City,Binzhou City and Heze City is far lower than the provincial average.Based on the population distribution,the Gini Coefficient of human resources on maternal and child health care in Shandong Province is about 0.20.the Gini cofficient in the eastern and western regions were both below 0.20,with the central region of between 0.20 and 0.30.The contribution rate of the Theil Index between group difference is higher than 80%.Based on the geographic configuration,the average Gini Coefficient is about 0.25,with the western region of below 0.20 and the eastern and central regions between 0.20 and 0.30.The contribution rate of group difference on Theil Index is higher than 90%.Conclusion The health resource on the maternal and child health care in Shandong Province is fairly equal,and the average equity of the population is better than geographic configuration.We should take population distribution into account as well as geographic configuration for further allocation of human resources on maternal and child health care.