Chinese General Practice ›› 2020, Vol. 23 ›› Issue (4): 409-413.DOI: 10.12114/j.issn.1007-9572.2019.00.783

Special Issue: 健康公平性最新文章合集

• Monographic Research • Previous Articles     Next Articles

Resource Allocation Equity of Chinese General Practitioners Based on Lorenz Curve and Gini Coefficient 

  

  1. 1.School of Nursing and Health,Henan University,Kaifeng 475000,China
    2.Department of General Practice,Henan Provincial People's Hospital,Henan University,Zhengzhou 450003,China
    3.Yunnan Cancer Hospital,Kunming 650118,China
    *Corresponding author:GU Jianqin,Chief physician,Master supervisor;E-mail:gujianqinzz@163.com
  • Published:2020-02-05 Online:2020-02-05

基于洛伦兹曲线和基尼系数的中国全科医生资源配置公平性研究

  

  1. 1.475000河南省开封市,河南大学护理与健康学院 2.450003河南省郑州市,河南大学河南省人民医院全科医学科 3.650118云南省昆明市,云南省肿瘤医院
    *通信作者:顾建钦,主任医师,硕士生导师;E-mail:gujianqinzz@163.com
  • 基金资助:
    国家自然科学基金资助项目(71603132);中国博士后科学基金面上项目(2018M632781);中央领导科技地方发展专项项目(Z135050009017);河南省软科学项目(182400410172)

Abstract: Background The resource allocation of general practitioners(GPs) is one of the basic indicators for the evaluation of health equity.At present,the research on the allocation equity of GPs in China is mostly limited to a single year or the regional data and lacks the research on the dynamic change trend of national data.Objective To analyze the fairness of the allocation of GPs in China from 2013 to 2017 in order to provide a reference for optimizing the allocation of GPs and strengthening its scientific management.Methods Based on the 2014—2017 China Health and Family Planning Statistical Yearbook and the 2018 China Health and Wellness Statistical Yearbook,we collected the number of GPs from each of its regions in China from 2013 to 2017.Lorenz curve and Gini coefficient were used to analyze the allocation equity of GPs in China from 2013 to 2017.Results From 2013 to 2017,the number of GPs in China increased from 145 511 to 252 717 with an increase of 107 206,and the number of GPs per 10 000 people increased from 1.07 to 1.82 with an increase of 0.75.The Lorenz curve of the distribution of Chinese GPs according to the service population was close to the line of absolute fairness,while the Lorenz curve according to the service area had deviated from the line of absolute fairness.The Gini coefficient of the distribution of Chinese GPs according to the service population in 2013—2017 was 0.29,0.26,0.25,0.24 and 0.24,respectively,and the Gini coefficient according to the service area was 0.73,0.72,0.72,0.72 and 0.73,respectively.Conclusion The allocation fairness of GPs by service population distribution is superior to that by service area distribution in China.The fairness by service population distribution is in a normal state,while that by service area distribution is in a highly dangerous state.The government should take measures to enhance the coordinated development of GP resources among different regions.

Key words: Health care rationing, General practitioners, Resource allocation, Lorenz curve, Gini coefficient

摘要: 背景 全科医生资源配置是评价卫生公平性的基础性指标之一,目前我国关于全科医生资源配置公平性的研究多局限于单一年份或区域性数据,缺乏对全国性数据动态变化趋势的研究。目的 对2013—2017年我国全科医生资源配置公平性进行分析,旨在为优化全科医生资源配置、加强对全科医生资源的科学管理提供参考依据。方法 以2014—2017年的《中国卫生和计划生育统计年鉴》和2018年的《中国卫生健康统计年鉴》为资料来源,收集2013—2017年全国及各地区全科医生数,并运用洛伦兹曲线和基尼系数对2013—2017年我国全科医生资源配置公平性进行分析。结果 2013—2017年,我国全科医生数从145 511人增加到252 717人,增加了107 206人;每万人口全科医生数从1.07人增加到1.82人,增加了0.75人。我国全科医生按服务人口分布的洛伦兹曲线比较接近绝对公平线,按服务面积分布的洛伦兹曲线偏离绝对公平线程度较大。2013—2017年按服务人口分布的基尼系数分别为0.29、0.26、0.25、0.24、0.24,按服务面积分布的基尼系数分别为0.73、0.72、0.72、0.72、0.73。结论 我国全科医生按服务人口配置公平性优于按服务面积配置公平性,按服务人口配置公平性在正常状态,而按服务面积配置公平性呈高度危险状态,政府应采取措施加强不同区域间全科医生资源的协调发展。

关键词: 卫生保健公平提供, 全科医生, 资源分配, 洛伦兹曲线, 基尼系数