海南省基本医疗卫生服务均等化分析

目的：了解海南省市县际间基本医疗卫生服务均等化现状,为促进全省基本医疗卫生服务均等化建设提供参考。方法：利用海南省、我国及经合组织国家等卫生统计数据,对海南省市县际间基本医疗卫生服务均等化指标进行分析。结果：资源分布均等化方面,机构地理可及性相差较大,医护比为1∶1.2,资源分布的基尼系数大于0.3；筹资均等化方面,人均医疗保健支出低于全国,人均政府卫生支出额高的市县主要集中在各区域的中心,多数市县新农合住院实际补偿比在50%左右；服务提供均等化方面,多数市县床位使用率低于90%,药费占比在30%～40%,地区之间孕产妇及儿童健康管理差距较小,但管理率普遍低于全国。结论：基本医疗卫生服务资源分布与政治、经济等条件有关,筹资机制不健全、基本医疗和公共卫生服务提供能力低影响了基本医疗卫生服务的质量。建议合理布局基本医疗卫生服务资源,加大卫生筹资力度,提高基本医疗卫生服务提供能力。

The equity of essential health care services in Hainan

Objective: To analyze essential health care equity in cities and counties of Hainan in order to provide the basis for its development. Methods: Based on health statistics of Hainan, China and OECD countries, indicators of essential health care equity in cities and counties were analyzed. Results: Equity in distribution of resources, the hospital geographical distance is large difference, physician-to-nurse ratio is 1:1.2, and the Gini coefficient is more than 0.3. Equity in financing, health care spending per capita is less than the national level. Cities and counties with high government budgets for health are located in regional centers. The hospitalization costs compensation with new rural cooperative medical scheme is about 50%. Equity in service supply, bed occupancy rate below 90% and drugs accounted for 30%~40% in most cities and counties. Regional differences in maternal and child health management are small, but below the national level. Conclusions: The situation of essential health care resources is related to the political and economic climate. Financing mechanisms for essential health care are imperfect; and a low supply of basic medical and public health services reduced the quality of essential health care. Suggestions: Rational distribution of essential health care resources should be promoted; essential health care financing should be increased; and the capability of essential health care supply should be improved.