中国循证医学杂志

中国循证医学杂志

四川省儿科卫生资源配置与公平性研究

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目的了解四川省儿科卫生服务需求、资源配置现状及公平性,为四川省儿科卫生资源的优化配置提供参考。方法问卷调查 2015 年四川省 183 个县(市、区)所有具有儿科医疗服务能力的医疗机构。采用两周就诊率、两周未就诊比例、住院率、需住院未住院比例来反应儿科卫生服务需求,采用基尼系数、洛伦兹曲线分析儿科卫生资源配置现状、公平性和可及性。结果四川省儿科卫生服务需求量大,资源配置呈“倒三角”。四川省儿科卫生资源:按人口分布,医师、床位、医疗设备的基尼系数分别为 0.47、0.40 和 0.49,均处于较不公平状态;按地理面积分布,医师、床位、医疗设备的基尼系数分别是 0.82、0.77 和 0.81,均处于绝对不公平状态。结论四川省儿科卫生资源总量不足、配置不合理、供需不均衡,资源匮乏与浪费并存。四川省儿科卫生资源按面积分布的公平性远低于按人口分布的公平性,优质儿科卫生资源的可及性较差。

ObjectiveTo investigate the demand of pediatric health service, the current situation of resource allocation and the equity of health service, so as to provide guidelines for optimizing the resource allocation of pediatric health service in Sichuan province.MethodsA questionnaire of all healthcare institutions with legal capability from a total of 183 prefectures in Sichuan province was performed in 2015. We described the demand of pediatric health service by two-week hospital visit rate, the proportion of no-visit rate within two-weeks, hospital admission rate, and the patient required hospitalization rate. We assessed current situation of resource allocation, equity and accessibility by analyzing Gini coefficient, Lorenz curve and thermodynamic diagram.ResultsThe demand of pediatric health service in Sichuan province was huge and the current resource allocation can be shown a " inverted triangle” form. According to population distribution, the Gini coefficients of physician, bed and equipment were 0.47, 0.40 and 0.49, respectively, which represented inequality in resource allocation. By location, the Gini coefficients of physician, bed and equipment were 0.82, 0.77 and 0.81, respectively, which indicated an absolutely unfair situation.ConclusionsThe health resources of pediatric in Sichuan province are limited, the distribution is unbalanced, and the supply of pediatric healthcare is not compatible with demand. The lack of resources and waste coexist simultaneously. Furthermore, the fairness of distribution in terms of geographical areas is far less than that in terms of population. The accessibility of superior health resources is low.

关键词: 儿科; 卫生服务需求; 卫生资源配置; 基尼系数; 公平性

Key words: Pediatric; Demand of health service; Health resource allocation; Gini coefficient; Fairness

引用本文: 曾文麒, 陶文娟, 严玲, 文进. 四川省儿科卫生资源配置与公平性研究. 中国循证医学杂志, 2018, 18(3): 267-270. doi: 10.7507/1672-2531.201710093 复制

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