Inequitable distribution of general practitioners in Australia: estimating need through the Robin Hood Index
Inequitable distribution of general practitioners in Australia: estimating need through the Robin Hood Index
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DOI：
10.1111/j.1467-842x.2000.tb00726.x
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发表时间：
2000-02-01
影响因子：
3.5
通讯作者：
Symon, B
中科院分区：
文献类型：
--
作者：
Wilkinson, D;Symon, B
目的：从人口普查数据，记录全科医生在澳大利亚的分布和估计的全科医生的数量需要实现一个公平的分布占社区health need.Methods：全科医生的位置，人口规模和粗死亡率的统计司（SD）的数据从澳大利亚统计局获得。按标准差计算每位全科医生的患者数量并绘图。使用粗死亡率来估计社区卫生需求，计算了全澳和每个SD（罗宾汉指数）的人均全科医生人数与死亡率的比率。结果：在57个SDs中，共有26，290名全科医生。每名全科医生平均为707人，从551人到1 887人不等。首都城市的标准差具有最有利的比率。澳大利亚的罗宾汉指数为1，从0.32（相对服务不足）到2.46（相对服务过度）不等。12个SD（21%），包括所有首府城市和65%的澳大利亚人，罗宾汉指数> 1。为了实现人均公平，需要增加2 489名全科医生（占目前劳动力的10%）。为了实现公平的罗宾汉指数3351（目前的劳动力的13%）是needed.Conclusions：在澳大利亚的全科医生的分布是倾斜的。非大都市地区的服务相对不足。人口普查数据和罗宾汉指数可以为确定澳大利亚的需求领域提供一种简单的方法。
Objective: From Census data, to document the distribution of general practitioners in Australia and to estimate the number of general practitioners needed to achieve an equitable distribution accounting for community health need.Methods: Data on location of general practitioners, population size and crude mortality by statistical division (SD) were obtained from the Australian Bureau of Statistics. The number of patients per general practitioner by SD was calculated and plotted. Using crude mortality to estimate community health need, a ratio of the number of general practitioners per person:mortality was calculated for all Australia and for each SD (the Robin Hood Index). From this, the number of general practitioners needed to achieve equity was calculated.Results: In all, 26,290 general practitioners were identified in 57 SDs. The mean number of people per general practitioner is 707, ranging from 551 to 1887. Capital city SDs have most favourable ratios. The Robin Hood Index for Australia is 1, and ranges from 0.32 (relatively under-served) to 2.46 (relatively over-served). Twelve SDs (21%) including all capital cities and 65% of all Australians, have a Robin Hood Index > 1. To achieve equity per capita 2489 more general practitioners (10% of the current workforce) are needed. To achieve equity by the Robin Hood Index 3351 (13% of the current workforce) are needed.Conclusions: The distribution of general practitioners in Australia is skewed. Nonmetropolitan areas are relatively underserved. Census data and the Robin Hood Index could provide a simple means of identifying areas of need in Australia.