2015—2017年广西卫生资源配置现状及公平性研究

目的:分析2015—2017年广西卫生资源配置及公平性情况,为进一步优化卫生资源配置提供参考。方法:采用洛伦兹曲线、基尼系数和泰尔指数从人口、地理、经济三个维度评价广西卫生资源配置公平性。结果:2015—2017年,广西卫生资源拥有量呈上升趋势;人口维度上洛伦兹曲线弯曲度最小,地理维度上弯曲度最大。2015年、2017年各项卫生资源在人口维度上基尼系数值的范围分别为0.0608~0.1505、0.0965~0.1494,地理维度上分别为0.2807~0.3114、0.2892~0.3336,经济维度上分别为0.1160~0.2610、0.1928~0.3079,泰尔指数分析结果显示,2017年各项卫生资源的总泰尔指数位于0.0148~0.1829之间,在人口与经济维度上多表现为组内贡献率>组间贡献率,地理维度上表现为组间贡献率>组内贡献率。结论:2015—2017年,广西卫生资源总量增加,但部分卫生资源配置不公平情况加剧,地区分布不均衡,按人口和经济配置的卫生人力资源公平性较好,但按地理配置的公平性有待提高。建议强化政府在卫生资源配置中的作用,改善地区间分布差异,使资源向落后、偏远地区倾斜,同时实施区域人才稳定政策。

Research on the current situation and equity of health resource allocation in Guangxi

Objective: To analyze the distribution and fairness of health resources in Guangxi from 2015 to 2017 so as to provide reference for further optimization of health resources allocation. Methods: Lorenz curve, Gini coefficient and Theil index were used to evaluate the equity of health resource allocation in Guangxi from three dimensions of population, geography and economy. Results: From 2015 to 2017, the amount of health resources in Guangxi has been basically undergoing an increasing trend. The Lorenz curve had the smallest curvature in the population dimension and the largest curvature in the geographic dimension. In 2015 and 2017, The range of Gini coefficient values in the population dimension is 0.060 8 to 0.150 5, 0.096 5 to 0.149 4, and in the geographical dimension is 0.280 7 to 0.311 4, 0.289 2 to 0.333 6, and in the economic dimension is 0.116 0 to 0.261 0, 0.192 8 to 0.307 9. The Theil analysis results showed that the total Theil index of various health resources in Guangxi ranged between 0.014 8 and 0.182 9 in 2017, and the intra-group contribution was greater than the inter-group contribution rate in terms of demographic and economic dimension. In the aspect of geographic dimension, the results showed a greater inter-group contribution rate than that recorded from within the groups. Conclusion: From 2015 to 2017, the total amount of health resources in Guangxi increased. However, the unfair allocation of some health resources was noticed for multiple occasions, the health resources allocation was uneven, and the equity of healthcare personnel was better in view of the population to be taken care of and the economy in place, even though the fairness of geographical allocation needed to be improved. It is hence suggested that the role of the government in the allocation of health resources should be improved, the distribution differences between regions should be avoided, resources should be more distributed in underdeveloped and remote areas, and at the same time implement and enhance regional talent stability policies.