北京市社區(qū)衛(wèi)生資源配置人口分布的公平性評價

莊倩　蔣艷　徐嘉顏

[摘要] 目的 對北京市社區(qū)衛(wèi)生資源配置的公平性進行分析評價，為北京市社區(qū)衛(wèi)生資源合理配置提供參考依據(jù)。 方法 數(shù)據(jù)來源于2016年度北京市社區(qū)衛(wèi)生服務(wù)管理中心“北京市社區(qū)衛(wèi)生服務(wù)常規(guī)監(jiān)測資料”和2016年北京市統(tǒng)計局統(tǒng)計數(shù)據(jù)，繪制洛倫茲曲線并計算基尼系數(shù)從人口分布的角度分析北京市社區(qū)衛(wèi)生機構(gòu)數(shù)、衛(wèi)生技術(shù)人員數(shù)、床位設(shè)備數(shù)、社區(qū)衛(wèi)生服務(wù)經(jīng)費投入等指標的均衡性和公平性。結(jié)果 從人口分布的角度來看，衛(wèi)生技術(shù)人員配置最為均衡，基尼系數(shù)為0.121，其中醫(yī)生與專職防保人員的基尼系數(shù)分別0.167和0.159；其次為設(shè)備配置、機構(gòu)配置和社區(qū)衛(wèi)生服務(wù)經(jīng)費投入，基尼系數(shù)分別為0.179、0.248和0.251；而社區(qū)衛(wèi)生服務(wù)經(jīng)費其中用于社區(qū)公共衛(wèi)生服務(wù)經(jīng)費的基尼系數(shù)為0.400，床位配置基尼系數(shù)為0.424，均表現(xiàn)出不公平性。 結(jié)論 北京市社區(qū)衛(wèi)生資源從人口角度的配置上整體較為公平，其中用于社區(qū)公共衛(wèi)生服務(wù)的經(jīng)費投入差距較大，城6區(qū)投入高于遠郊10區(qū)，應(yīng)更多地考慮公共衛(wèi)生服務(wù)經(jīng)費投入的合理配置。

[關(guān)鍵詞] 北京市社區(qū)衛(wèi)生服務(wù)；資源配置；人口分布；公平性；基尼系數(shù)

[中圖分類號] R197 [文獻標識碼] A [文章編號] 1673-7210（2018）03（c）-0146-04

[Abstract] Objective To analyze and evaluate the equity of community health resources distribution in Beijing， and to provide reference basis for the rational allocation of community health resources in Beijing. Methods Data sources came from 2016 Beijing Community Health Service Management Center "Beijing Community Health Service routine monitoring data" and 2016 Beijing Statistical Offices statistics. Drew Lorenz curve and calculated the Gini coefficient， the balance and fairness of the indexes such as number of community health institutions， number of health technicians， number of beds， and expenditure for Community health Service are analyzed from the angle of population distribution. Results From the point of view of population distribution， the distribution of health technicians was the most balanced，Gini coefficient was 0.121， in which the Gini coefficient of doctors and allied insurance personnel was 0.167 and 0.159 respectively. The second was equipment allocation， organization allocation and expenditure for community health service， Gini coefficient was 0.179， 0.248 and 0.251. While the Gini coefficient of expenditure for community public health services was 0.400， and the Gini coefficient of beds was 0.424， all of which show unfairness. Conclusion The community health resources distribution in Beijing are fairly fair by population distribution， among which the expenditure for community public health service is not fair enough， the investment of urban area is higher than that of suburb， and the reasonable allocation of public health service outlay should be considered more.

[Key words] Community health service in Beijing； Resource allocation； Population distribution； Equity； Gini coefficient

衛(wèi)生資源配置公平性是指要公正、平等地分配各種可利用的衛(wèi)生資源，使整個人群都能有相同的機會從中受益[1]。隨著社會經(jīng)濟和科技的發(fā)展，人們對健康的需求日益增加，衛(wèi)生服務(wù)資源的合理配置對于衛(wèi)生事業(yè)持續(xù)、穩(wěn)定、快速、健康的發(fā)展具有重要的促進作用。……