Paramita Sekar Ayu, Yamazaki Chiho, Setiawati Elsa Pudji, Koyama Hiroshi
Department of Public Health, Gunma University, Maebashi, Japan.
Department of Public Health, Universitas Padjadjaran, Bandung, Indonesia.
Int J Health Plann Manage. 2018 Apr;33(2):e586-e596. doi: 10.1002/hpm.2506. Epub 2018 Mar 11.
Indonesia has been decentralized since 2001, and we evaluated the distribution trends of physicians, puskesmas (community health centers), hospitals, and hospital beds in 34 provinces in Indonesia for 2000 to 2014. Inequality index of Gini showed improvement of the distribution of physicians and decreased from 0.38 to 0.29. The indices in distributions of hospitals and hospital beds also decreased from 0.26 to 0.17 and from 0.25 to 0.18, respectively. However, the index in the distribution of puskesmas increased from 0.19 to 0.28. We also investigated the legislative transitions of the laws concerning health resources and found the strong affects of compulsory work laws for physicians and the increment of health budget. In the decentralization era, the local governments have some political autonomy for the development of health resources; however, the national government should monitor the nationwide distribution of health resources and advice necessary recommendations to the local governments.
印度尼西亚自2001年起实行权力下放，我们评估了2000年至2014年期间印度尼西亚34个省份医生、社区卫生中心、医院及医院床位的分布趋势。基尼不平等指数显示医生分布情况有所改善，从0.38降至0.29。医院及医院床位分布指数也分别从0.26降至0.17以及从0.25降至0.18。然而，社区卫生中心的分布指数从0.19升至0.28。我们还研究了有关卫生资源法律的立法转变，发现医生强制工作法及卫生预算增加产生了重大影响。在权力下放时代，地方政府在卫生资源发展方面拥有一定政治自主权；然而，中央政府应监测全国卫生资源分布情况，并向地方政府提供必要建议。
