Liu Wen, Liu Ying, Twum Peter, Li Shixue
Department of Social Medicine and Health Management, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China.
Department of Epidemiology and Biostatistics, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China.
Int J Equity Health. 2016 Apr 19;15:68. doi: 10.1186/s12939-016-0357-1.
The inequitable allocation of health resources is a worldwide problem, and it is also one of the obstacles facing for health services utilization in China. A new round of health care reform which contains the important aspect of improving the equity in health resource allocation was released by Chinese government in 2009. The aim of this study is to understand the changes of equity in health resource allocation from 2009 to 2013, and make a further inquiry of the main factors which influence the equity conditions in China.
Data resources are the China Health Statistics Yearbook (2014) and the China Statistical Yearbook (2014). Four indicators were chosen to measure the trends in equity of health resource allocation. Data were disaggregated by three geographical regions: west, central, and east. Theil index was used to calculate the degree of unfairness.
The total amount of health care resources in China had been increasing in recent years. However, the per 10, 000 km(2) number of health resources showed a huge gap in different regions, and per 10, 000 capita health resources ownership showed a relatively small disparities at the same time. The index of health resources showed an overall downward trend, in which health financial investment the most unfair from 2009 to 2012 and the number of health institutions the most unfair in 2013. The equity of health resources allocation in eastern regions was the worst except for the aspect of health technical personnel allocation. The regional contribution rates were lower than that of the inter-regional contribution rates which were all beyond 60 %.
The equity of health resource allocation improved gradually from 2009 to 2013. However, the internal differences within the eastern region still have a huge impact on the overall equity in health resource allocation. The tough issues of inequitable in health resource allocation should be resolved by comprehensive measures from a multidisciplinary perspective.
卫生资源分配不公是一个全球性问题，也是我国卫生服务利用面临的障碍之一。2009年，中国政府启动了新一轮医改，其中一个重要方面是提高卫生资源分配的公平性。本研究旨在了解2009年至2013年卫生资源分配公平性的变化，并进一步探究影响我国公平状况的主要因素。
数据来源为《中国卫生统计年鉴（2014）》和《中国统计年鉴（2014）》。选取四个指标来衡量卫生资源分配公平性的趋势。数据按西部、中部和东部三个地理区域进行分解。采用泰尔指数计算不公平程度。
近年来，我国卫生资源总量一直在增加。然而，每万平方公里卫生资源数量在不同地区存在巨大差距，而每万人口卫生资源拥有量差距相对较小。卫生资源指数总体呈下降趋势，其中2009年至2012年卫生财政投入最不公平，2013年卫生机构数量最不公平。除卫生技术人员分配方面外，东部地区卫生资源分配公平性最差。区域贡献率低于区域间贡献率，区域间贡献率均超过60%。
2009年至2013年，卫生资源分配公平性逐步提高。然而，东部地区内部差异对卫生资源分配总体公平性仍有巨大影响。应从多学科角度采取综合措施解决卫生资源分配不公这一棘手问题。
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