中国农村卫生事业管理

目的 分析我国医疗卫生资源的配置状况，为推进医疗卫生资源的结构优化和布局调整提供参考。方法 运用描述统计、卫生资源密度指数(HRDI)、洛伦兹曲线、基尼系数和集中指数等方法，以医疗卫生机构、床位、执业(助理)医师和注册护士为指标，对我国医疗卫生资源的配置状况和公平性进行分析与评价。结果 我国医疗卫生资源总量呈增长趋势，目前我国各地区医疗卫生资源占全国总量的比值从高到低依次为东部、西部、中部、东北部地区；按HRDI值的我国医疗卫生资源从高到低依次为床位、注册护士、执业(助理)医师、医疗卫生机构，且西部地区各类医疗卫生资源的HRDI值均低于全国HRDI值；我国各类医疗卫生资源按人口分布的基尼系数均为0～0.23之间，床位、执业(助理)医师按人口分布的公平性优于注册护士、医疗卫生机构；按地理面积分布的基尼系数均为0.15～0.67之间，医疗卫生资源配置不均衡；我国医疗卫生资源的集中指数均为正值，集中指数从大到小依次为执业(助理)医师、注册护士、床位、医疗卫生机构。结论 我国地区间医疗卫生资源配置差异较大，医疗卫生人力资源配置的公平性需优化，医疗卫生资源配置的人口公平性优于地理公平性，且存在经济水平较高的地区拥有更多医疗卫生资源的现象。

Objective To analyze the allocation status of healthcare resources in China, so as to provide reference for promoting the structural optimization and layout adjustment of the resources. Methods Descriptive statistics, Health Resource Density Index(HRDI), Lorenz curve, Gini coefficient and concentration index were used to analyze and evaluate the allocation status and fairness of China's healthcare resources using healthcare institutions, beds, practicing(assistant) physicians and registered nurses as indicators. Results The total amount of healthcare resources in China was in a growing trend, and currently, the ratios of healthcare resources in each region of China to the total amount of the nation from high to low were those of the eastern, western, central and northeastern regions. According to the HRDI value, China's healthcare resources in descending order were those for the beds, registered nurses, practicing(assistant) physicians, and healthcare institutions, and the HRDI values for all types of healthcare resources in the western region were lower than the national HRDI values. The Gini coefficients by population distribution for all types of healthcare resources in China were all between 0 and 0.23, and the equity in beds, practicing(assistant) physicians by population distribution was better than that in registered nurses and healthcare institutions; the Gini coefficients by geographic area were all between 0.15 and 0.67, and the distribution of healthcare resources was not balanced. The concentration indices of healthcare resources in China were all positive, and the concentration indices were, in descending order, those of practicing(assistant) physicians, registered nurses, beds, and healthcare institutions. Conclusions There are great differences in the allocation of healthcare resources between regions in China, and the fairness of the allocation of healthcare human resources needs to be optimized; the demographic fairness of the allocation of healthcare resources is better than the geographic fairness, and there is a phenomenon that regions with higher economic levels have more healthcare resources.