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中国公共卫生资源的现状与分布均衡性

Current situation and distribution equality of public health resource in China.

作者信息

Yao Honghui, Zhan Chaohong, Sha Xinping

机构信息

Department of Learning, Informatics, Management and Ethics, Karolinska Institute, 171 77 Stockholm, Sweden.

Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008 Hunan Province China.

出版信息

Arch Public Health. 2020 Sep 22;78:86. doi: 10.1186/s13690-020-00474-3. eCollection 2020.

Abstract

BACKGROUND

The public health system has been developed in China for several years while no research explores its distribution. This research aims to describe the variation and equality of public health allocation from 2013 to 2018 and explore the source of inequality.

METHODS

Data in this research was obtained from the China Health Statistics Yearbook 2014 to 2019 and the China Statistical Yearbook 2019. Four indicators were chosen in describing the development and current situation of the public health system. Three of them were used to evaluate allocation equality. 31 provinces were categorized into western, middle, and eastern groups based on geographical and economic conditions. Total allocation equality, inter- and intra-difference were all measured by the Theil index.

RESULTS

All indicators showed a stably upwards trend except for the number of public health institutions. The allocation gap of the public health institution per km was larger than that per 10,000 capita. Theil index of three indicators continually rose from 2013 to 2018 and the inequality of public health institutions allocation was the highest one. The western region had the highest Theil index in technical personnel and beds allocation. Among the three regions, the western region contributed most to inequality.

CONCLUSIONS

The public health workforces and institutions are still under the requirement of the National Medical and Health Service System Plan. From 2013 to 2018, the equality of public health resources stably decreases, which is mainly contributed by the internal difference within the western region. Further research should be done to explore the possible cause of the results. Problems founded in this research should be solved by multisectoral cooperation.

摘要

背景

中国公共卫生体系已发展多年,但尚无研究探讨其分布情况。本研究旨在描述2013年至2018年公共卫生资源分配的差异与公平性,并探究不平等的根源。

方法

本研究的数据来自《中国卫生统计年鉴(2014 - 2019)》和《中国统计年鉴(2019)》。选取了四个指标来描述公共卫生体系的发展和现状。其中三个指标用于评估分配公平性。根据地理和经济条件,将31个省份分为西部、中部和东部三组。总分配公平性、组间和组内差异均采用泰尔指数进行衡量。

结果

除公共卫生机构数量外,所有指标均呈稳定上升趋势。每平方公里公共卫生机构的分配差距大于每万人的分配差距。2013年至2018年,三个指标的泰尔指数持续上升,公共卫生机构分配的不平等程度最高。西部地区在技术人员和床位分配方面的泰尔指数最高。在这三个地区中,西部地区对不平等的贡献最大。

结论

公共卫生人力和机构仍未达到《国家医疗卫生服务体系规划》的要求。2013年至2018年,公共卫生资源的公平性稳步下降,这主要是由西部地区内部差异造成的。应进一步开展研究,探究造成这一结果的可能原因。本研究发现的问题应通过多部门合作来解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4e9/7510281/9b696ba1ce04/13690_2020_474_Fig1_HTML.jpg

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