| ObjectiveTo analyze the present situation of health resources in community health service institutions in Henan province,and to understand the existing problems of health resource allocation.Using three methods to assess the equality of health resources of community health service institutions in Henan.Based on the results of the study,the purposes are to perfect the health resources allocation and to provide objective basis for the administrative department of public health policy for the government.MethodsUsing descriptive analysis to analyze the construction situation of community health service institutions in Henan province from 2009 to 2015,including the community health service organization scale,the allocation of resources,assets operation,etc.To analyze the health resource allocation’s overall fairness from the population distribution and geographical distribution by using the Gini coefficient.Using Theil index to measure the fairness of the interregional and intra-regional in Henan province;using concentration index to analyze the influence of financial condition on the equity of health resource allocation.Results1.The basic construction of institutions: the number of community health service institutions in Henan province increased from 726 to 1316 from 2009 to 2015,community health service centers are mainly set up by government,community health service stations are mainly set up by society and personal.While there are 40.58% of them which were not included into medical insurance fixed-point units,and 12.39% of them did not reach the infrastructure construction standards.2.Development of health resources: the number of practitioners(assistants)physicians per ten thousand in Henan community health service institution increased from 4.15 to 4.18,and the number of registered nurse from 3.11 to 3.60.The number of public health physicians and general practitioners is 0.23 and 1.49 respectively in 2015,and the ratio of doctor and nurse is1:0.86;the building floor area of community health service centers and stations are 1980.07m2 and 192.87m2 respectively,the number of beds per ten thousand increased from 4.42 to 5.98,the ratio of utilization increased from 42.23% to 51.27%,the average number of beds per institution is 24.29 and observation bed is 2.41.Equipment allocation rate is lower than 60.00% in 2015,and the proportion of financial aid,medical and drug income are 27.58%,32.62%,38.09% respectively.3.Analysis of human resources equity: The Gini coefficient of health human resources was from 0.2 to 0.4 in 2009.In 2015,The Gini coefficient of practitioners(assistants)physicians,registered nurse and general practitioners calculated by population distribution were 0.1615、0.1755、0.2517 respectively,and were 0.2423、0.2191、0.2517 respectively calculated by geographical distribution.The total Thiel index is 0.0209-0.0403,distribution rate in group were 87.88%、74.13%、68.57% respectively;The concentration index were 0.0114、0.0620、0.0678 respectively.4.Analysis of material resources equity: The Gini coefficient of material resources is between 0.3 and 0.7,and the Gini coefficient of institution,number of beds,the equipment over ten thousand yuan were 0.2885、0.2803、0.2279 respectively calculated by human distribution,and the Gini calculated by geographical distribution were 0.2895、0.3087、0.3059 respectively.The total Thiel index was between 0.447 and 0.0696,distribution rate in group were 81.09%、61.78%、92.66% respectively;The concentration index were 0.0241、-0.0683、0.0249 respectively.5.Analysis of financial resources equity: The Gini coefficient of financial aid was between 0.4 and 0.6,the Gini coefficient calculated by human distribution was 0.2487 in 2015,the Gini coefficient calculated by geographical distribution was 0.2490.The total Thiel index was 0.0457,distribution rate in group increased from 19.224% to 68.42%;The concentration index was 0.1112.Conclusions1.The community health service institution has great development in Henan province,while some cities still can not reach the national standards,and cities have great difference.The government should strengthen the supervision of community health service institutions,strict standards for admittance into community health service institutions and increase government investment,improve the construction of various types of health facilities.2.The health resources allocation is equity in community health service institution in Henan province,the equity of human distribution is better than that of geographical distribution;the equity of health resources allocation is mainly influenced by intra area health resources allocation;practitioners(assistants)physicians,registered nurse,institutions and aid income have become concentration into higher-income areas,and the beds allocation has become concentration into lower-income areas,and the rest of resources still remain inequity.3.The government should consider regional factors in health policy,increase the geographic accessibility of community health service,especially economic underdeveloped regions,reasonably adjust community health resources distribution,increase the government’s support for the community. |
PDF Full Text Request