Song Peige, Ren Zhenghong, Chang Xinlei, Liu Xuebei, An Lin
Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100191, China.
Int J Environ Res Public Health. 2016 Jul 12;13(7):703. doi: 10.3390/ijerph13070703.
Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the paediatric workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation.
几十年来,儿童健康一直是全球和国家层面的优先事项。在中国,儿科医生短缺的问题长期以来一直备受争议,然而,评估儿科劳动力分布在人口和地理方面不平等的证据有限。本研究旨在通过洛伦兹曲线、基尼系数和泰尔L指数分析中国儿科劳动力(包括儿科医生和儿科护士)分布的不平等情况,数据来自2010年全国妇幼卫生人力资源抽样调查。在本研究中,我们发现,对于7岁以下儿童的分布,儿科劳动力分布最不公平,除中部地区外,儿科劳动力的地理分布在全国范围内存在非常严重的不平等。对于不同专业类型,我们发现,除中部地区外,儿科护士在人口和地理分布方面的不平等程度均高于儿科医生。区域内不平等是儿科劳动力分布不平等的主要来源。总之,本研究首次揭示了中国儿科劳动力分布不足的情况,2010年全国儿科劳动力分布仍存在严重不平等,仍需要更多研究来探索不平等的深层次原因,特别是城乡差异以及省内和省际差异,并指导国家和地方的卫生政策制定和资源分配。