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1930 - 1990年墨西哥医生的地区分布:一项政策评估

The regional distribution of doctors in Mexico, 1930-1990: a policy assessment.

作者信息

Nigenda G

机构信息

National Institute of Public Health, Avenida Universidad, Morelos, Mexico.

出版信息

Health Policy. 1997 Feb;39(2):107-22. doi: 10.1016/s0168-8510(96)00864-0.

Abstract

The results of the doctor distributional policy in Mexico is evaluated. Despite the government's efforts to achieve a better distribution of doctors throughout the country between 1930 and 1990, important disparities still exist among geographic areas. Diverse factors ranging from the underdevelopment of some areas, to the resistance of doctors to leave the urban areas, are related to this unequal distribution. Early programmes aimed at redressing the original distribution in the 1930's had limited effects. In subsequent years, additional programmes were implemented. However, a lack of coordination and the short time span of many programmes produced only minor changes to the distributional pattern. Although in recent years the distribution has improved, southern states still suffer an acute scarcity while northern states have a relative abundance. Finally, the paper discusses how economic, political and social variables, as well as the structure of the health system, have shaped the current distribution of Mexican doctors.

摘要

对墨西哥医生分配政策的结果进行了评估。尽管政府在1930年至1990年间努力在全国实现医生的更优分配,但不同地理区域之间仍存在重大差距。从一些地区的不发达到医生不愿离开城市地区等各种因素,都与这种不平等分配有关。20世纪30年代旨在纠正初始分配的早期项目效果有限。在随后的几年里,又实施了其他项目。然而,缺乏协调以及许多项目的时间跨度较短,对分配模式仅产生了微小变化。尽管近年来分配情况有所改善,但南部各州仍然严重短缺,而北部各州则相对充裕。最后,本文讨论了经济、政治和社会变量以及卫生系统结构如何塑造了墨西哥医生目前的分配状况。

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