National equity of health resource allocation in China: data from 2009 to 2013.
National equity of health resource allocation in China: data from 2009 to 2013.
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DOI：
10.1186/s12939-016-0357-1
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发表时间：
2016-04-19
影响因子：
4.8
通讯作者：
Li S
中科院分区：
文献类型：
--
作者：
Liu W;Liu Y;Twum P;Li S
卫生资源配置不公平是一个世界性问题，也是我国卫生服务利用面临的障碍之一。2009年，我国政府出台了新一轮医疗卫生改革，其中包含了改善卫生资源配置公平性的重要内容。本研究旨在了解2009 - 2013年我国卫生资源配置公平性的变化，并进一步探讨影响我国卫生资源配置公平性的主要因素。数据来源为《中国卫生统计年鉴（2014）》和《中国统计年鉴（2014）》。选择了四个指标来衡量卫生资源分配的公平性趋势。数据按三个地理区域分列：西部、中部和东部。泰尔指数被用来计算不公平的程度。近年来，中国卫生资源总量不断增加。但各地区间每万km 2卫生资源拥有量存在较大差距，而人均每万km 2卫生资源拥有量差异较小。卫生资源指数总体呈下降趋势，2009 - 2012年卫生财政投入最不公平，2013年卫生机构数量最不公平。除卫生技术人员配置方面外，东部地区卫生资源配置的公平性最差。区域贡献率低于区域间贡献率，区域间贡献率均超过60%。2009 - 2013年卫生资源配置公平性逐步改善。但东部地区内部的差异仍对卫生资源配置的整体公平性产生巨大影响。卫生资源配置不公平的坚韧，应从多学科角度采取综合措施加以解决。
The inequitable allocation of health resources is a worldwide problem, and it is also one of the obstacles facing for health services utilization in China. A new round of health care reform which contains the important aspect of improving the equity in health resource allocation was released by Chinese government in 2009. The aim of this study is to understand the changes of equity in health resource allocation from 2009 to 2013, and make a further inquiry of the main factors which influence the equity conditions in China. Data resources are the China Health Statistics Yearbook (2014) and the China Statistical Yearbook (2014). Four indicators were chosen to measure the trends in equity of health resource allocation. Data were disaggregated by three geographical regions: west, central, and east. Theil index was used to calculate the degree of unfairness. The total amount of health care resources in China had been increasing in recent years. However, the per 10, 000 km2 number of health resources showed a huge gap in different regions, and per 10, 000 capita health resources ownership showed a relatively small disparities at the same time. The index of health resources showed an overall downward trend, in which health financial investment the most unfair from 2009 to 2012 and the number of health institutions the most unfair in 2013. The equity of health resources allocation in eastern regions was the worst except for the aspect of health technical personnel allocation. The regional contribution rates were lower than that of the inter-regional contribution rates which were all beyond 60 %. The equity of health resource allocation improved gradually from 2009 to 2013. However, the internal differences within the eastern region still have a huge impact on the overall equity in health resource allocation. The tough issues of inequitable in health resource allocation should be resolved by comprehensive measures from a multidisciplinary perspective.