Zhou Yuanna, Han Lin, Zhang Wuxing, Fan Yujun, Liu Wenjian, Liu Muzi, Fan Yishan, Qu Xiaoyuan
School of Nursing and Health, Henan University, Kaifeng, Henan, People's Republic of China.
Risk Manag Healthc Policy. 2024 Aug 19;17:1987-2005. doi: 10.2147/RMHP.S466680. eCollection 2024.
China has made considerable efforts to promote the development of maternal and child health (MCH) care since the new health system reform in 2009. This study aims to evaluate the trend and equity of MCH resources allocation in China from 2008 to 2020 and provide a reference for rational distribution of MCH resources.
Data were collected from the China Health Statistics Yearbook and China Statistics Yearbook. The number of MCH hospitals, licensed (assistant) physicians, registered nurses and beds were selected for the measurement of the equity of MCH resources allocation. The Health Resource Agglomeration Degree and Theil index were used in evaluating MCH resource allocation equity and to compare differences among regions.
From 2008 to 2020, the average annual growth rates for MCH hospitals, beds, licensed (assistant) physicians, and registered nurses were 0.72%, 6.95%, 5.04%, and 9.57%, respectively. However, regional disparities in the equity of MCH resource allocation have been identified. Although the western region has shown growth in MCH resource allocation by geography, the agglomeration degree of the four indicators remains less than 1, significantly lower than the average value of greater than 2 in the eastern region. Additionally, the equity of human resource allocation in the western region is lower than the equity in the allocation of institutions. In the densely populated eastern region, the equity of MCH resource allocation by population is decreasing, with the agglomeration degree of all four indicators below 1 in 2020. The disparity in healthcare resource allocation within regions is the main cause of inequitable MCH resource allocation in China.
The allocation of MCH resources in China has improved since 2009, however, geographic equity needs further improvement, particularly in densely populated regions. Population and geographic balances should be considered in the development and implementation of MCH resource allocation policies, and improving intraregional equity should be the focus.
自2009年新医改以来，中国在促进妇幼保健（MCH）事业发展方面做出了巨大努力。本研究旨在评估2008年至2020年中国妇幼保健资源配置的趋势和公平性，为合理分配妇幼保健资源提供参考。
数据来源于《中国卫生统计年鉴》和《中国统计年鉴》。选取妇幼保健院数量、执业（助理）医师、注册护士和床位数量来衡量妇幼保健资源配置的公平性。采用卫生资源集聚度和泰尔指数评估妇幼保健资源配置公平性并比较地区间差异。
2008年至2020年，妇幼保健院、床位、执业（助理）医师和注册护士的年均增长率分别为0.72%、6.95%、5.04%和9.57%。然而，已发现妇幼保健资源配置公平性存在地区差异。虽然西部地区按地理区域划分的妇幼保健资源配置有所增长，但四项指标的集聚度仍小于1，显著低于东部地区大于2的平均值。此外，西部地区人力资源配置的公平性低于机构配置的公平性。在人口密集的东部地区，按人口计算的妇幼保健资源配置公平性正在下降，2020年所有四项指标的集聚度均低于1。地区内医疗资源配置的差异是中国妇幼保健资源配置不公平的主要原因。
自2009年以来，中国妇幼保健资源配置有所改善，但地理公平性仍需进一步提高，特别是在人口密集地区。在制定和实施妇幼保健资源配置政策时，应考虑人口和地理平衡，提高区域内公平性应成为重点。
