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中国湖南省妇幼保健资源配置的公平性与效率

Equity and efficiency of maternal and child health resources allocation in Hunan Province, China.

机构信息

Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, People's Republic of China.

Health Commission of Hunan Province, Changsha, 410008, People's Republic of China.

出版信息

BMC Health Serv Res. 2020 Apr 15;20(1):300. doi: 10.1186/s12913-020-05185-7.

Abstract

BACKGROUND

A reasonable allocation of health resources is often characterized by equity and high efficiency. This study aims to evaluate the equity and efficiency of maternal and child health (MCH) resources allocation in Hunan Province, China.

METHODS

Data related to MCH resources and services was obtained from the Hunan maternal and child health information reporting and management system. The Gini coefficient and data envelopment analysis (DEA) were employed to evaluate the equity and efficiency of MCH resources allocation, respectively.

RESULTS

The MCH resources allocation in terms of demographic dimension were in a preferred equity status with the Gini values all less than 0.3, and the Gini values for each MCH resources' allocation in terms of the geographical dimension ranged from 0.1298 to 0.4256, with the highest values in the number of midwives and medical equipment (≥ CNY 10,000), which exceeds 0.4, indicating an alert of inequity. More than 40% regions in Hunan were found to be relatively inefficient with decreased return to scale in the allocation of MCH resources, indicating those inefficient regions were using more inputs than needed to obtain the current output levels.

CONCLUSIONS

The equity of MCH resources by population size is superior by geographic area and the disproportionate distribution of the number of medical equipment (≥ CNY 10,000) and midwives between different regions was the main source of inequity. Policy-makers need to consider the geographical accessibility of health resources among different regions to ensure people in different regions could get access to available health services. More than 40% of regions in Hunan were found to be inefficient, with using more health resources than needed to produce the current amount of health services. Further investigations on factors affecting the efficiency of MCH resources allocation is still needed to guide regional health plans-making and resource allocation.

摘要

背景

卫生资源的合理配置通常以公平和高效为特征。本研究旨在评价中国湖南省妇幼保健资源配置的公平性和效率。

方法

从湖南省妇幼保健信息报告和管理系统中获取与妇幼保健资源和服务相关的数据。采用基尼系数和数据包络分析(DEA)分别评价妇幼保健资源配置的公平性和效率。

结果

人口维度的妇幼保健资源配置处于偏好公平状态,基尼系数均小于 0.3;地理维度的每一项妇幼保健资源配置的基尼系数范围为 0.1298 至 0.4256,其中助产士人数和医疗设备(≥人民币 10000 元)的基尼系数最高,超过 0.4,表明存在不公平的警报。湖南省超过 40%的地区发现资源配置效率相对较低,存在规模报酬递减,表明这些低效率地区在获得当前产出水平时使用的投入超过了所需。

结论

人口规模的妇幼保健资源公平性优于地理区域,不同地区医疗设备(≥人民币 10000 元)和助产士数量的分配不均是不公平的主要来源。决策者需要考虑不同地区卫生资源的地理可达性,以确保不同地区的人们能够获得可利用的卫生服务。湖南省超过 40%的地区发现效率低下,在获得当前卫生服务量时使用了过多的卫生资源。需要进一步研究影响妇幼保健资源配置效率的因素,以指导区域卫生规划制定和资源配置。

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