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2021 年中国重庆市卫生资源配置公平性研究:一项横断面研究。

Equity of health resource allocation in Chongqing, China, in 2021: a cross-sectional study.

机构信息

School of Public Health, Chongqing Medical University, Chongqing, China.

Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.

出版信息

BMJ Open. 2024 Jan 18;14(1):e078987. doi: 10.1136/bmjopen-2023-078987.

Abstract

BACKGROUND

Chongqing, the most populous city in Southwest China. This study aims to examine the equity of health resource allocation in Chongqing using the latest statistics, analyse possible shortcomings and propose strategies to address these issues.

METHODS

This cross-sectional study used healthcare resource, population, area and gross domestic product data from the Seventh National Census Bulletin of Chongqing, the National County Statistical Yearbook, the Chongqing Municipal Bureau of Statistics and the Chongqing Health Statistical Yearbook 2022. We also studied the equity of health resource allocation in Chongqing by using the Gini coefficient, Lorenz curve and Theil index, and used the Analytical Hierarchy Process and Technique for Order of Preference by Similarity to Ideal Solution (AHP-TOPSIS) method to comprehensively evaluate the health resources in the four major regions of Chongqing.

RESULTS

The Gini coefficient of health resources in Chongqing in 2021 was the highest when allocated according to geographical area, between 0.4285 and 0.6081, both of which exceeded 0.4, and the Gini coefficient of medical equipment was the highest and exceeded 0.6. The inter-regional Theil index of each resource was greater than the intraregional Theil index, and the contribution of inter-regional differences ranged from 64.83% to 80.21%. The results of the AHP-TOPSIS method showed that the relative proximity between health resources and ideal solutions in four regions of Chongqing ranged from 0.0753 to 0.9277.

CONCLUSION

The allocation of health resources in Chongqing exhibits pronounced inequities, particularly in the distribution of medical equipment according to geographical area. Moreover, there exists a substantial gap in the equity of health resource allocation among the four regions of Chongqing. As such, this study emphasises the need for Chongqing, China, to prioritise the equitable allocation of health resources and increase consideration of geographic factors. Implementing measures to promote equitable allocation of health resources, particularly in geographic terms, is critical.

摘要

背景

重庆,中国西南地区人口最多的城市。本研究旨在利用最新统计数据考察重庆市卫生资源配置的公平性,分析可能存在的不足,并提出解决这些问题的策略。

方法

本横断面研究使用了重庆市第七次全国人口普查公报、全国县域统计年鉴、重庆市统计局和重庆市卫生统计年鉴 2022 年的数据,包括卫生资源、人口、面积和国内生产总值。我们还使用基尼系数、洛伦兹曲线和泰尔指数研究了重庆市卫生资源配置的公平性,并使用层次分析法和逼近理想解排序法(AHP-TOPSIS)综合评价了重庆市四大区域的卫生资源。

结果

2021 年,按地理区域分配时,重庆市卫生资源的基尼系数最高,在 0.4285 到 0.6081 之间,均超过 0.4,医疗设备的基尼系数最高且超过 0.6。各资源的区域间泰尔指数均大于区域内泰尔指数,区域间差异的贡献度在 64.83%至 80.21%之间。AHP-TOPSIS 法的结果表明,重庆市四个区域的卫生资源与理想解的相对接近度在 0.0753 到 0.9277 之间。

结论

重庆市卫生资源配置存在明显的不公平现象,特别是按地理区域分配医疗设备。此外,重庆市四个区域的卫生资源配置公平性存在较大差距。因此,本研究强调重庆市需要优先考虑卫生资源的公平分配,并更多地考虑地理因素。实施促进卫生资源公平分配的措施,特别是在地理方面,至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83dc/10806633/7bad0fb606cf/bmjopen-2023-078987f01.jpg

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