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目的探讨湖南省死因回顾调查点的卫生资源配置的现状和公平性。方法收集湖南省10个死因回顾调查点的社会经济和疾病监测基础数据,运用描述性分析、Lorenz曲线和Gini系数等方法评价卫生资源配置的合理性和公平性。结果湖南省死因回顾调查点每千人口医师、护师(士)和床位数分别为1.5、1.0和2.5。城市、农村点院均床位医师比、院均床位护士比分别是1:0.66、1:0.57和1:0.54、1:0.31。病床、卫生技术人员按面积分布的基尼系数为0.46和0.39,按人口分布的基尼系数为0.31和0.27。城市和农村居民的脑血管病、呼吸系统疾病、恶性肿瘤、心脏病死亡率差异均有统计学意义(P<0.05),损伤与中毒的死亡率城乡差异无统计学意义(P>0.05)。结论 2005年湖南省死因回顾调查点卫生资源城乡分布结构不合理,虽然病床、卫生技术人员按人口配置公平性较好,但按面积配置公平性达到警戒线。调查点城乡居民疾病死亡率差异与卫生资源的配置公平性有关。
Objective To investigate the status quo and equity of the allocation of health resources in the retrospective investigation of causes of death in Hunan Province. Methods The data of socioeconomic and disease surveillance in 10 retrospective investigation points in Hunan province were collected. The descriptive analysis, Lorenz curve and Gini coefficient were used to evaluate the rationality and fairness of health resource allocation. Results In the retrospective investigation of death causes in Hunan Province, the number of doctors, nurses and nurses per 1,000 population and the number of beds were 1.5, 1.0 and 2.5 respectively. The ratio of hospital beds to hospital beds in rural and urban hospitals was 1: 0.66, 1: 0.57 and 1: 0.54, 1: 0.31 respectively. The Gini coefficients for beds, health technicians by area were 0.46 and 0.39, and the Gini coefficients for population distribution were 0.31 and 0.27. The difference of cerebrovascular disease, respiratory system disease, malignant tumor and heart disease mortality between urban and rural residents was statistically significant (P <0.05). There was no significant difference between the urban and rural mortality rate of injury and poisoning (P> 0.05). Conclusion In 2005, the cause of death in Hunan Province was retrospectively investigated. The distribution of health resources in urban and rural areas was irrational. Although the fairness of the beds and health technicians in population allocation was good, the fairness of the allocation of area to the warning line reached the warning line. The differences in mortality rates of disease between urban and rural residents at the investigation point are related to the fairness of allocation of health resources.