基于基尼系数和集聚度的西藏地区医疗资源配置公平性分析

目的 分析西藏地区医疗资源配置现状及公平性，为西藏地区医疗资源配置提供参考意见。 方法 运用基尼系数和集聚度的方法，分析2012—2020年西藏地区7个地市的床位数、卫生技术人员数、执业（助理）医师数、注册护士数的公平性。结果 按地理面积指标衡量时，基尼系数的评价结果均大于0.4，处于不公平状态；以人口分布指标衡量基尼系数时，医疗资源配置全部处于公平状态；那曲市和阿里地区的医疗资源集聚度小于1，医疗资源的地理可及性较差；拉萨市和林芝市的医疗资源集聚度均高于人口集聚度，医疗资源配置充足，而西藏其他地市的医疗资源配置相对不足。结论 提高西藏地区医疗资源配置地理公平性；缩短西藏地区西北部与东南部的医疗资源配置的差距；推动西藏地市间跨区域医疗服务体系建设规划，建立边境移动医疗新机制；优化卫生技术人员配置，探索一体化的卫生医疗人才管理模式。

Equity analysis of medical resources allocation in Tibet based on Gini coefficient and agglomeration degree

Objective To analyze the current situation and fairness of medical resource allocation in Tibet, and to provide reference for medical resource allocation in Tibet. Methods Using the method of Gini coefficient and agglomeration degree, the fairness of the number of beds, the number of health technicians, the number of licensed (Assistant) doctors and the number of registered nurses in seven prefectures and cities in Tibet from 2012 to 2020 were analyzed. Results When measured by geographical area indicators, the evaluation results of the Gini coefficient were all greater than 0.4, which was in an unfair state; when the Gini coefficient was measured by population distribution indicators, the allocation of medical resources was all in a fair state. In Nagqu City and Ali, the concentration of medical resources was less than 1, and the geographical accessibility of medical resources was poor. The concentration of medical resources in Lhasa and Nyingchi was higher than the population concentration, and the allocation of medical resources was sufficient, while the other cities in Tibet had relatively insufficient allocation of medical resources. Conclusion Improve the geographical fairness of medical resource allocation in Tibet; shorten the difference of medical resource allocation between northwest and southeast Tibet; promote the construction plan of the cross-regional medical service system between Tibet and cities, and establish a new border mobile medical mechanism; optimize Health technical personnel allocation, and explore an integrated health care talent management model.