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中国少数民族地区重症监护病房床位资源分配公平性——基于地理和人口维度的实证分析

Equity of intensive care unit bed resource allocation in ethnic minority areas of China-an empirical analysis based on geographical and population dimensions.

作者信息

Zhou Junxu, Peng Rong, Feng Jun, Kang Jing, Deng Meng, Meng Shanshan, Qin Xianjing, Lu Decheng

机构信息

School of Public Policy and Management, Guangxi University, Nanning, China.

Health Policy Research Center, Guangxi Medical University, Nanning, Guangxi, China.

出版信息

BMJ Open. 2024 Dec 20;14(12):e083203. doi: 10.1136/bmjopen-2023-083203.

DOI:10.1136/bmjopen-2023-083203
PMID:39806683
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11667435/
Abstract

OBJECTIVE

The purpose of this study is to analyse the changes in the equity of intensive care unit (ICU) bed allocation in 14 cities in China's Guangxi Zhuang Autonomous Region from 2018 to 2021, to identify the problems in the process of ICU bed allocation in China's ethnic minority regions.

DESIGN

The Gini coefficient, Theil index, health resource density index, and spatial correlation analysis were used to analyse the current status of ICU bed resource allocation and allocation equity in Guangxi, China, on two dimensions: geography, and population.

SETTING

The Guangxi Zhuang Autonomous Region.

RESULTS

The number of ICU beds configured by geographic and population dimensions in Guangxi basically showed a growing trend. The ICU bed allocation by population dimensions was in a state of absolute equity, and the equity of geographic dimension was in a state of basic reasonableness. The contribution rate of intraregional differences is higher than that of inter-regional differences. There is a localised spatial aggregation of ICU bed resource allocation, with a low health resource density index and a higher proportion of lack of ICU beds in cities with a high concentration of ethnic minority populations, such as Hechi, Chongzuo, Baise, Hezhou, and Laibin.

CONCLUSIONS

The total amount of ICU bed resources increased, but the regional distribution was not balanced. The equity of ICU beds allocated by population and economy was better than that by geography, the unfairness of ICU bed allocation was mainly caused by intraregional differences, and the lack of the number of ICU beds was greater in the economically underdeveloped ethnic minority areas. Exchanges and cooperation between regions should be strengthened to promote the coordinated development of ICU bed resources between regions.

摘要

目的

本研究旨在分析2018年至2021年中国广西壮族自治区14个城市重症监护病房(ICU)床位分配公平性的变化,找出中国少数民族地区ICU床位分配过程中存在的问题。

设计

采用基尼系数、泰尔指数、卫生资源密度指数和空间相关性分析,从地理和人口两个维度分析中国广西ICU床位资源配置现状及分配公平性。

地点

广西壮族自治区。

结果

广西按地理和人口维度配置的ICU床位数基本呈增长趋势。按人口维度的ICU床位分配处于绝对公平状态,地理维度的公平性处于基本合理状态。区域内差异的贡献率高于区域间差异。ICU床位资源配置存在局部空间集聚现象,少数民族人口高度集中的城市,如河池、崇左、百色、贺州和来宾,卫生资源密度指数较低,ICU床位短缺比例较高。

结论

ICU床位资源总量增加,但区域分布不均衡。按人口和经济分配的ICU床位公平性优于按地理分配,ICU床位分配不公平主要由区域内差异造成,经济欠发达的少数民族地区ICU床位数量缺口较大。应加强区域间交流合作,促进区域间ICU床位资源协调发展。

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