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中国精神卫生床位分布的公平性评估:基于 2011 年至 2020 年的纵向数据。

Equity assessment of the distribution of mental health beds in China: based on longitudinal data from 2011 to 2020.

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030, Shanghai, China.

Shanghai Center for Mental Disease Control and Prevention, 200030, Shanghai, China.

出版信息

BMC Health Serv Res. 2022 Nov 30;22(1):1453. doi: 10.1186/s12913-022-08658-z.

Abstract

BACKGROUND

Mental health problems have become a public health problem that needs to be solved in China. However, medical resources for mental healthcare remain insufficient and unevenly distributed. The Chinese central government has taken many measures to address this issue over the last decade. This study aimed to evaluate the changes in equity in mental health bed allocation from 2011 to 2020.

METHODS

The data of this study came from the China Health Statistical Yearbook (2012-2021) and the China National Administrative Division Information Platform. The annual growth rate was used to evaluate the time trends of mental health beds. The Lorenz curve, Gini coefficient and Theil index were used to assess equity in the demographic and geographical dimensions. The distribution of mental health beds was visualized on a map using geographic information system (GIS) software.

RESULTS

The total number of mental health beds in China increased steadily from 2011 to 2020. At the national level, the Gini coefficient and Theil index all exhibited downward trends over time. The mental health bed allocation in terms of the demographic dimension was relatively equitable, with Gini values all less than 0.3; however, the Gini coefficients by geographical area were all more than 0.6, indicating inequity. Intraregional contribution rates were higher than interregional contribution rates, which were all above 60%.

CONCLUSION

The overall distribution equity of mental health beds improved from 2011 to 2020. The equity of mental health beds in terms of population size is superior to that in terms of geographical area. Intraregional differences are the main source of inequity. In particular, differences within the western region need to be given attention. Thus, the findings from this study emphasize that the demographic and geographical distributions and all influencing factors should be considered when the government makes mental health resource allocation policies.

摘要

背景

心理健康问题已成为中国亟待解决的公共卫生问题。然而,精神卫生医疗资源仍然不足且分布不均。中国中央政府在过去十年中采取了许多措施来解决这个问题。本研究旨在评估 2011 年至 2020 年精神卫生床位配置公平性的变化。

方法

本研究的数据来自《中国卫生统计年鉴》(2012-2021 年)和中国国家行政区划信息平台。使用年度增长率来评估精神卫生床位的时间趋势。洛伦兹曲线、基尼系数和泰尔指数用于评估人口统计学和地理维度的公平性。使用地理信息系统(GIS)软件对精神卫生床位的分布进行地图可视化。

结果

中国的精神卫生床位总数从 2011 年到 2020 年稳步增加。在国家层面,基尼系数和泰尔指数随时间均呈下降趋势。从人口统计学维度来看,精神卫生床位的配置相对公平,基尼系数均小于 0.3;然而,按地理区域划分的基尼系数均大于 0.6,表明存在不公平。区域内的贡献率高于区域间的贡献率,均高于 60%。

结论

2011 年至 2020 年,精神卫生床位的总体分布公平性有所提高。从人口规模来看,精神卫生床位的公平性优于地理区域。区域内的差异是不公平的主要来源。特别是,西部地区的内部差异需要引起关注。因此,本研究的结果强调,政府在制定精神卫生资源配置政策时,应考虑人口统计学和地理分布以及所有影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a2/9710066/53c6ced4a070/12913_2022_8658_Fig1_HTML.jpg

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