上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（公共卫生） • 上一篇    下一篇

人口流动视域下重庆市公共卫生资源配置的公平性分析

陈菲1，张培林2，郑万会2，钟晓妮1，徐祥龙1，谭华伟1,2   

  1. 1.重庆医科大学 公共卫生与管理学院医学与社会研究中心  健康领域社会风险预测治理协同创新中心, 重庆 400016; 2.重庆市第九人民医院成本控制研究室, 重庆 400700
  • 出版日期:2015-08-28 发布日期:2015-09-30
  • 作者简介:陈菲(1974—)， 女， 副教授， 博士; 电子信箱: chenfei6639@126.com。
  • 基金资助:

    重庆市统筹城乡医疗卫生改革发展区域卫生规划研究(CHSR1)

Analysis of the equity of public health resources allocation in Chongqing from the perspective of migration

CHEN Fei1, ZHANG Pei-lin2, ZHENG Wan-hui2, ZHONG Xiao-ni1, XU Xiang-long1, TAN Hua-wei1,2   

  1. 1.Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; 2.Department of Cost Control Research, Chong Qing Ninth People's Hospital, Chongqing 400700, China
  • Online:2015-08-28 Published:2015-09-30
  • Supported by:

    Regional Health Planning for Reform Development Balanced Urban-Rural in Chongqing, CHSR1

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摘要：

目的  综合考虑重庆市城乡人口流动规模和方向，实证分析2009—2012年重庆市公共卫生资源配置的公平性。方法  综合运用基尼系数和尺度方差,从户籍人口和常住人口角度对医改以来重庆市区域公共卫生资源配置公平性进行综合测度和分析。结果  历年户籍人口和常住人口配置的公共卫生技术人员基尼系数均值为0.212 2和0.177 1，差异具有统计学意义（P<0.05）；历年户籍人口和常住人口配置的公共卫生支出基尼系数均值为0.480 0和0.413 3，差异具有统计学意义（P<0.05）；历年户籍人口和常住人口配置的公共卫生业务用房面积基尼系数均值为0.357 5和0.251 1，差异具有统计学意义（P<0.05）。户籍人口配置的公共卫生技术人员、公共卫生支出、公共卫生业务用房面积历年平均县际尺度方差贡献率依次为63.35%、57.37%和79.39%；常住人口配置的公共卫生技术人员、公共卫生支出、公共卫生业务用房面积历年平均县际尺度方差贡献率为85.48%、47.18%和78.11%。结论  城乡间公共卫生资源配置公平性存在差异；县际差异是重庆市公共卫生资源配置差异主要来源；按人口流动的大小和方向配置能促进区域公共卫生资源配置公平性。

关键词: 人口流动, 公共卫生资源, 公平性, 基尼系数, 尺度方差

Abstract:

Objective  To empirically analyze the equity of the allocation of the public health resources in Chongqing from 2009 to 2012 according to the scale and direction of rural-urban migration. Methods  The Gini coefficient and scale variance were used to evaluate and analyze the equity of the allocation of the public health resources in Chongqing area since healthcare reform from the perspectives of registered population and permanent population. Results   The mean Gini coefficients of public health technical personnel for registered population and permanent population were 0.212 2 and 0.177 1 and the difference was statistically significant (P<0.05). The mean Gini coefficients of public health expenditure for registered population and permanent population were 0.480 0 and 0.413 3 and the difference was statistically significant (P<0.05). The mean Gini coefficients of public health work area for registered population and permanent population were 0.357 5 and 0.251 1 and the difference was statistically significant (P<0.05). The contributions of county scale variance of public health technical personnel, public health expenditure, and public health work area of registered population were 63.35%, 57.37%, and 79.39%. The contributions of county scale variance of public health technical personnel, public health expenditure, and public health work area of permanent population were 85.48%, 47.18%, and 78.11%. Conclusion  The equity of public health resources allocation of urban and rural areas is different. The difference among counties is the main cause of the difference of public health resource allocation in Chongqing. Location of public health resources based on scale and direction of rural-urban migration can promote the equity of regional public health resources allocation.

Key words: migration, public health resources, fairness, Gini coefficient, scale variance