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

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。

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

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.