Distribution Equity and Development Trend of General Practitioners in Shandong Province during 2013—2016

doi:10.12114/j.issn.1007-9572.2020.00.019

Abstract

Abstract: Background　General practitioners（GPs），the 'gatekeeper' of residents' health，play a major role in delivering primary healthcare services in China.Vigorously developing the GP force is a key task of the ongoing pharmaceutical and healthcare reform in China.Objective　To analyze the distribution equity and development trend of GPs in Shandong Province from 2013 to 2016.Methods　Data of GPs，population and geography were collected from Shandong Health and Family Planning Statistical Yearbook（2014—2017） and Shandong Statistical Yearbook（2014—2017）.Gini coefficient and Theil index were used to analyze the allocation equity of GPs.Results　The number of GPs in Shandong Province increased from 7 709 in 2013 to
11 377 in 2016，with an annual growth rate of 13.85% during the 5-year period.The number of GPs per 10 000 people increased from 0.80 to 1.14，with an average annual growth rate of 12.53%.The majority of GPs have obtained a GP certification after training.The Gini coefficient for GPs distribution by population and geographical distribution decreased from 0.282 3 to 0.205 8，and from 0.290 4 to 0.259 2，respectively.The Theil index for GPs distribution by population and geographical distribution fell from 0.125 3 to 0.068 8，and from 0.136 3 to 0.106 9，respectively.Whether it was by population or geographical configuration，the intra-regional differences contributed more than 94% to the total in the allocation of GPs.Conclusion　The number of GPs in Shandong Province is growing year by year，but the growth rate is limited.The training mode of GPs needs to be optimized.The distribution equity of GPs is generally good，and the intra-area differences of eastern，central and western parts are the main influencing factors of equity.

Key words: Health care rationing, General practitioners, Gini coefficient, Theil index, Shandong

摘要： 背景　全科医生作为居民健康的“守门人”，是我国基层医疗卫生服务的主力军，大力发展全科医生队伍是当前我国医药卫生事业改革的重点工作之一。目的　分析2013—2016年山东省全科医生配置现状及公平性趋势。方法　查阅2014—2017年《山东省卫生计生统计年鉴》和《山东省统计年鉴》，获取全科医生数量、人口、地理面积数据，采用基尼系数和泰尔指数对全科医生配置进行公平性分析。结果　2013—2016年山东省全科医生数从7 709人增加到11 377人，年均增长率为13.85%。每万人口全科医生数从0.80人增至1.14人，年均增长率为12.53%。2013—2016年每年全科医生均以取得全科医生培训合格证书的人员为主。全科医生配置按人口分布的基尼系数从0.282 3下降到0.205 8，按地理面积分布的基尼系数从0.290 4下降到0.259 2；按人口分布的泰尔指数从0.125 3下降到0.068 8，按地理面积分布的泰尔指数从0.136 3下降到0.106 9。不论是按人口分布配置还是按地理面积分布配置，组内差异对全科医生配置总差异的贡献率均在94%以上。结论　山东省全科医生队伍逐年壮大，但增速有限，培养模式有待优化；全科医生配置公平性总体良好，东部、中部、西部地区内部差异是公平性的主要影响因素。

关键词: 卫生保健公平提供, 全科医生, 基尼系数, 泰尔指数, 山东

CHENG Yanmin,XU Yanfei,WEN Nan, et al. Distribution Equity and Development Trend of General Practitioners in Shandong Province during 2013—2016　[J]. Chinese General Practice, 2020, 23(4): 414-418. DOI: 10.12114/j.issn.1007-9572.2020.00.019.
程艳敏,徐燕飞,温楠等. 2013—2016年山东省全科医生配置现状及公平性趋势研究[J]. 中国全科医学, 2020, 23(4): 414-418. DOI: 10.12114/j.issn.1007-9572.2020.00.019.

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