基于时空计量分析方法的我国卫生资源配置现状研究

目的基于我国2013—2019年卫生资源分配在“人口公平性”与“地理公平性”存在的差异,以此对我国医疗卫生资源配置的公平性进行一个较为全面的评估。方法通过计算基尼系数和绘制洛伦兹曲线对卫生机构数、卫生机构床位数、卫生技术人员数、执业医师数、注册护士数五个指标分别按人口公平性与地理公平性分析我国2013—2019年卫生资源分配现状,使用空间相关分析结合基尼系数和洛伦兹曲线的综合视角考察我国医疗卫生资源配置公平性。结果卫生资源配置人口和地理的基尼系数分别在0.055~0.186和0.614~0.679之间,各类医疗卫生资源按人口配置相对公平,而按面积配置则较为不公平,我国卫生资源分配的空间公平性分析显示,卫生资源数据在总体空间分布上具有一定的空间自相关性。局域空间自相关分析发现卫生资源无论按人口还是地理主要分布在中东部地区,说明全国卫生资源分配仍不均衡。结论我国卫生资源分配存在地区差异,从人口、地域分布特点出发的同时,应充分考虑包括地理条件、人口因素、经济发展等在内的各类影响区域卫生配置的条件,全面优化我国卫生人力资源配置结构。

Current situation of health resource allocation in China based on spatio-temporal econometric analysis

Objective To make a more comprehensive evaluation on the fairness of medical and health resource allocation in China based on the differences between population equity and geographical equity in China’s health resource allocation from 2013 to 2019. Methods By calculating Gini coefficient and Lorentz curve, the current situation of health resource allocation in China from 2013 to 2019 was analyzed according to population equity and geographical equity by using five indicators, the number of health institutions, the number of beds in health institutions, the number of health technicians, the number of licensed doctors and the number of registered nurses. We used spatial correlation analysis combined with Gini coefficient and Lorentz curve to investigate the fairness of medical and health resource allocation in China. Results The Gini coefficients of population and geography of health resource allocation were 0.055-0.186 and 0.614-0.679, respectively. The allocation of various medical and health resources based on population was relatively fair, while the allocation according to area was relatively unfair. Spatial equity analysis of health resource allocation in China showed that the data of health resources had a certain spatial autocorrelation in the overall spatial distribution. Local spatial autocorrelation analysis displayed that health resources were mainly distributed in the eastern central region according to population and geography, indicating that the allocation of health resources in China was still unbalanced. Conclusion There are regional differences in the allocation of health resources in China. Based on the characteristics of population and regional distribution, we should fully consider all kinds of conditions that affect the allocation of regional health resources, including geographical conditions, demographic factors and economic development, and fully optimize the allocation structure of human resources for health in China.