目的通过对我国医药卫生资源区域空间分布的研究,以期为政府优化配置卫生资源提供政策依据。方法将我国划分为3大经济和地理区域,选取6类医药卫生资源指标,依据2009年国家公布的31个省区的相关统计数据,应用变异系数、基尼系数、泰尔指数评价我国医药卫生资源区域空间分布的差异性。结果每万人口生物制药企业拥有量区域问的分布差异最大,而医疗机构床位数的配置分布差异相对最小。生物制药企业和三级医院万人口拥有量的区域问极差排在前2位。东部地区是6项资源在3大地理区域间或区域内的差异贡献的最大者,经济相对落后地区是形成执业(助理)医师、床位、三级医院和药品生产企业分布区域内差异的主要贡献者,而经济发达地区对地区政府人均医疗卫生支出和生物制药企业区域间分布差异的贡献最大。总体上,经济发展水平高的地区,其人口资源拥有率也相对更高。但是,两者之间并不完全呈正比关系。结论6类资源在我国区域间的分布均未表现出“相对合理”的状态。为更好地满足地区人群的卫生需求,政府应加大对经济不发达的西部地区生物制药产业和三级医院建设的投入,提高经济发达地区资源的有效利用和防止低水平重复建设,持续关注人均医药卫生的支出比例和执业医师的数量与质量。
Objective Analyzing the regional distribution discrepancy of medical and health resources in China, with the purpose of providing the government with policy making evidences for optimizing medical and health resource allocation. Results Dividing China into three regions based on regional economic development and geographic setting, and selecting 6 indicators for medical and health resources. On the basis of the statistics of 31 provinces released by the state in 2009, analyzing the inter- provincial disparities of the distribution of these six resources, by means of the coefficient of variation, Gini coefficient and Theil index. Methods The largest inter-regional allocation disparity is found in the number of biopharmaceutical manufacturing companies per ten thousand population. And the smallest discrepancy is found in the number of hospital beds among these regions. The top two extreme differences of resource possession per ten thousand population between the maximum and the minimum region are the number of biopharmaceutical manufacturing companies and tertiary hospitals. The eastern region is the largest contributor to the discrepancy of allocation for the six resources within and between regions. The less developed regions contribute the most inte~regional discrepancy for the allocation of medical practitioners (their assistants included), hospital beds, tertiary hospitals and pharmaceutical companies. And the developed regions contribute the most inter-regional discrepancy of medical finance support from local governments and the most of the allocation of biopharmaceutical manufacturing companies. In general, regions of higher development enjoy greater possession of the six resources per population in such regions. But these two are not always in direct proportion. Conclusion Regional distribution disparity of the six resources is not yet "reasonable" in China. To better meet the health needs of the population in various regions, the government is expected to increase its financial support for buildin