南京市2010—2014年卫生资源配置公平性分析
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1.南京医科大学公共卫生学院;2.南京医科大学医政学院

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The equity analysis for 2010-14 health resource allocation in Nanjing
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1.Nanjing Medical University the school of public health,JIANG SU NANJING;2.Nanjing Medical University the school of medical policy,JIANG SU NANJING

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    摘要:

    目的:分析南京市卫生资源配置(Health Resource Allocation, HRA)的公平性。 方法:收集南京市2010-2015年卫生机构、病床床位、执业(助理)医师以及注册护士数据。 运用泰尔指数对主城、江北和宁南三个区域各项卫生资源按照常住人口配置的状况和公平性进行分析。结果:卫生机构配置的总泰尔指数于2010-2013年从0.03558下降到0.00533,2014年又上升为0.02199;主城、江北、宁南内部指数于2010-2013年下降,2014年上升;区域间差异的贡献率逐年减小,2014年主城内部差异的贡献率达到60.72%。床位配置的总泰尔指数于2010-2012年持续下降,2013-2014年小幅上升,区域间指数总体下降;主城内部指数在0.05201-0.05539区间波动,江北、宁南内部指数总体呈下降趋势;2014年主城内部差异的贡献率达到63.36%。卫技人员、执业医师和注册护士的总泰尔指数持续下降;主城内部指数始终较高,江北和宁南内部指数持续下降;区域间差异和主城内部差异的贡献率均接近或超过50%。结论:南京市2010-2014年各项卫生资源总量持续增长;人均HRA公平性总体上持续增强;区域间及主城内部差异是导致HRA不公平的主要原因;江北和宁南内部HRA公平性较好。

    Abstract:

    【Abstract】 Objective:To analyze the equity of Nanjing health resource allocation(HRA). Methodology: collect data of health care facilities, hospital beds, practicing doctors including assistant doctors and practicing nurses. The Theil indices are used to analyze and evaluate the equity of 2010-14 health resource allocation in Nanjing by splitting it into three regions: major city, Jiang bei area and south area. Results: For health care facility, total Theil index of health care facilities decreases in 2010-13, and went up in 2014; so were the three areas. For hospital beds allocation, the total Theil index decreased gradually 2010-12, and increased slightly in 2013-14, and the overall inter-regional indices decreases. The intra-regional index fluctuated between 0.05201 and 0.05539 in the major city, but has trend of degrading in Jiang bei area and south area. For medical personnel, the total Theil indices decreased gradually. The intra-regional index of the major city was always high, while it decreased in the other two areas. The contribution rates of both inter- and intra-regional inequality are close or over 50%. Conclusion:The total amounts of each health resource increased in Nanjing in 2010-14, and the overall equality of HRA per capita was enhanced. The HRA inequality is dominated by inter-regional inequality and inequality in the major city.

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  • 收稿日期:2016-04-10
  • 最后修改日期:2016-06-15
  • 录用日期:2016-08-23
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