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2010 年至 2020 年中国中医卫生资源分布差距和公平性的变化趋势。

Trends in the disparities and equity of the distribution of traditional Chinese medicine health resources in China from 2010 to 2020.

机构信息

School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.

School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.

出版信息

PLoS One. 2022 Oct 10;17(10):e0275712. doi: 10.1371/journal.pone.0275712. eCollection 2022.

Abstract

BACKGROUND

At present, improving the accessibility to traditional Chinese medicine (TCM) health resources is an important component of China's health policy. This study evaluated the trends in the disparities and equity of TCM health resource allocation from 2010 to 2020 to inform optimal future local health planning and policy.

METHOD

The data for this study were extracted from the China Health Statistical Yearbook (2011-2021) and China Urban Statistical Yearbook (2020). The equity and rationality of the allocation of TCM health resources at the national and provincial levels were evaluated using the Gini coefficient and the health resource aggregation degree, respectively.

RESULT

The number of TCM-related institutions, beds, health staff, outpatients and admissions increased by 1.97, 2.61, 2.35, 1.72 and 2.41 times, respectively, between 2010 and 2020. The population-based Gini coefficients for health staff, beds and institutions were 0.12, 0.23 and 0.13, respectively, indicating acceptable equity, while the geographical area-based Gini index for health staff, beds and institutions were 0.65, 0.62 and 0.62, respectively, indicating serious inequity. The agglomeration degree as a function of geographical area was as follows: eastern region > central region > western region. Moreover, the institutional and health staff gaps between the geographical areas increased from 2012 to 2020. In addition, there was a relatively balanced agglomeration degree based on the population in these three regions and an increasingly equitable allocation of institutions and health staff.

CONCLUSION

In recent years, China's TCM health resources and services have increased rapidly, but their proportions within the overall health system remain low. The equity and rationality of TCM health allocated by the population was better than that by the geographic area. Regional differences and inequalities, especially for institutions, still exist. A series of policies to promote the balanced development of TCM need to be implemented.

摘要

背景

目前,提高中医药健康资源可及性是中国卫生政策的重要组成部分。本研究评估了 2010 年至 2020 年中医药卫生资源分配差距和公平性的趋势,为未来最佳的地方卫生规划和政策提供信息。

方法

本研究的数据来自《中国卫生统计年鉴》(2011-2021 年)和《中国城市统计年鉴》(2020 年)。分别采用基尼系数和卫生资源集聚度评价全国和省级中医药卫生资源配置的公平性和合理性。

结果

2010 年至 2020 年,中医药相关机构、床位、卫生人员、门诊和住院人数分别增长 1.97、2.61、2.35、1.72 和 2.41 倍。卫生人员、床位和机构的人口基尼系数分别为 0.12、0.23 和 0.13,表明公平性尚可,而卫生人员、床位和机构的地理基尼指数分别为 0.65、0.62 和 0.62,表明公平性严重不足。地理区域的集聚度为:东部地区>中部地区>西部地区。此外,2012 年至 2020 年,地理区域之间的机构和卫生人员差距扩大。此外,这三个地区的人口集聚度相对均衡,机构和卫生人员的分配更加公平。

结论

近年来,中国中医药卫生资源和服务快速增长,但在整个卫生系统中的比例仍然较低。人口配置的中医药卫生公平性和合理性优于地理区域配置。地区差异和不平等依然存在,特别是在机构方面。需要实施一系列促进中医药平衡发展的政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/335d/9550081/8268f1725523/pone.0275712.g001.jpg

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