基于集中指数的河南省卫生服务利用公平性分析
|
摘要
目的评价河南省卫生服务利用的公平性,为政府区域卫生规划及实施提供依据。方法运用集中指数及其分解法计算河南省卫生服务利用相关指标的集中指数和各影响因素对不公平性的贡献率。结果 2011-2015年河南省总诊疗人次数的集中指数为-0. 0811、-0. 0996、-0. 0896、-0. 0954、-0. 0969,入院人数的集中指数为-0. 0741、-0. 0868、-0. 0700、-0. 0676、-0. 0662; 2015年常住人口、人均GDP、城镇化水平、死亡率对门诊服务利用不公平性的贡献率为158. 4%、-84. 15%、66. 83%、-34. 22%,对住院服务利用不公平性的贡献率为277. 48%、-134. 62%、1. 82%、-29. 82%。结论河南省卫生服务利用整体公平性较好;常住人口、人均GDP、城镇化水平、死亡率对河南省门诊与住院服务利用不公平性的贡献率较大;未来政府需要兼顾居民多样化的卫生服务需求,发挥市场优势,提高河南省卫生服务利用均等化程度。
Objective To evaluate the fairness of health services in Henan and to provide feasible suggestions for government's regional health planning. Methods The concentration index and its decomposition method were used to calculate the concentration index of related health services utilization indexes and the contribution rate of influence factors to the unfairness. Results The concentration indexes of outpatients in Henan from 2011 to 2015 were-0. 0811,-0. 0996,-0. 0896,-0. 0954,-0. 0969,respectively. And the concentration indexes of inpatients were-0. 0741,-0. 0868,-0. 0700,-0. 0676,-0. 0662,respectively. In 2015,the contribution rates of permanent residents,per capita GDP,urbanization level and mortality rate to outpatient services utilization were 158. 4%,-84. 15%,66. 83%,-34. 22%,respectively. For inpatient services utilization,these were 277. 48%,-134. 62%,1. 82%,-29. 82%,respectively. Conclusion The health services utilization is fairly equitable in Henan. Permanent population,per capita GDP,urbanization level and mortality rate contribute significantly to the unfairness of outpatient and inpatient services. The government needs to consider the diversified health service demands of the residents,to give full play to the market advantages,and to improve the equalization of health services utilization.
Objective To evaluate the fairness of health services in Henan and to provide feasible suggestions for government's regional health planning. Methods The concentration index and its decomposition method were used to calculate the concentration index of related health services utilization indexes and the contribution rate of influence factors to the unfairness. Results The concentration indexes of outpatients in Henan from 2011 to 2015 were-0. 0811,-0. 0996,-0. 0896,-0. 0954,-0. 0969,respectively. And the concentration indexes of inpatients were-0. 0741,-0. 0868,-0. 0700,-0. 0676,-0. 0662,respectively. In 2015,the contribution rates of permanent residents,per capita GDP,urbanization level and mortality rate to outpatient services utilization were 158. 4%,-84. 15%,66. 83%,-34. 22%,respectively. For inpatient services utilization,these were 277. 48%,-134. 62%,1. 82%,-29. 82%,respectively. Conclusion The health services utilization is fairly equitable in Henan. Permanent population,per capita GDP,urbanization level and mortality rate contribute significantly to the unfairness of outpatient and inpatient services. The government needs to consider the diversified health service demands of the residents,to give full play to the market advantages,and to improve the equalization of health services utilization.
引文
[1]姚中宝,张帆,孙玉凤,等.某省居民卫生服务利用的公平性分析[J].中国卫生事业管理,2016,33(7):517-519,546.
[2]赵杨,冯宇彤,陈琳,等.老年人群医疗服务利用公平性影响因素研究[J].中国卫生政策研究,2017,10(2):74-80.
[3]李越.我国居民卫生服务利用预测和公平性研究[D].济南:山东大学,2016.
[4]沈迟,陶星星,董琬月,等.利用集中指数评价西安市卫生资源配置公平性[J].中国卫生政策研究,2015,8(1):69-73.
[5] Jenkins S. Calculating Income Distribution Indices from MicroData[J]. National tax journal,1988,41(1):139-142.
[6] Wagstaff A,Doorslaer EV. Measuring and testing for inequity in the delivery of health care[J]. Journal of Human Resources,2000,35(4):716-733.
[7]高建民,王小合,陈金宏,等.卫生资源配置标准编制方法研究[J].中国卫生事业管理,2001,17(6):374-375.
[8]张国杰.经济水平排序下我国中老年人卫生服务利用公平性及其分解研究[D].济南:山东大学,2013.
[9]张馨予,赵临,夏青,等.运用集中指数评价法对我国省域卫生资源配置的公平性分析[J].中华医院管理杂志,2014,30(1):2-5.
[10]高建民,周忠良,闫菊娥,等.我国基本医疗保障制度卫生服务可及性实证研究[J].中国卫生经济,2010,29(7):5-8.
[11]高建民,卢丽,张小龙,等.陕西省某县不同收入人群健康状况及卫生服务利用研究[J].现代预防医学,2014,41(20):3725-3727.
[12]王谨,李新辉,吾曲孔·买买提肉孜,等.南疆克州柯尔克孜族牧民卫生服务需要与利用现状调查[J].现代预防医学,2018(1):75-79.
[2]赵杨,冯宇彤,陈琳,等.老年人群医疗服务利用公平性影响因素研究[J].中国卫生政策研究,2017,10(2):74-80.
[3]李越.我国居民卫生服务利用预测和公平性研究[D].济南:山东大学,2016.
[4]沈迟,陶星星,董琬月,等.利用集中指数评价西安市卫生资源配置公平性[J].中国卫生政策研究,2015,8(1):69-73.
[5] Jenkins S. Calculating Income Distribution Indices from MicroData[J]. National tax journal,1988,41(1):139-142.
[6] Wagstaff A,Doorslaer EV. Measuring and testing for inequity in the delivery of health care[J]. Journal of Human Resources,2000,35(4):716-733.
[7]高建民,王小合,陈金宏,等.卫生资源配置标准编制方法研究[J].中国卫生事业管理,2001,17(6):374-375.
[8]张国杰.经济水平排序下我国中老年人卫生服务利用公平性及其分解研究[D].济南:山东大学,2013.
[9]张馨予,赵临,夏青,等.运用集中指数评价法对我国省域卫生资源配置的公平性分析[J].中华医院管理杂志,2014,30(1):2-5.
[10]高建民,周忠良,闫菊娥,等.我国基本医疗保障制度卫生服务可及性实证研究[J].中国卫生经济,2010,29(7):5-8.
[11]高建民,卢丽,张小龙,等.陕西省某县不同收入人群健康状况及卫生服务利用研究[J].现代预防医学,2014,41(20):3725-3727.
[12]王谨,李新辉,吾曲孔·买买提肉孜,等.南疆克州柯尔克孜族牧民卫生服务需要与利用现状调查[J].现代预防医学,2018(1):75-79.