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目的:评价东中西部城市政府医疗机构补助受益的公平性。方法:利用2011年8个社区卫生综合改革典型城市居民健康询问调查数据,采用受益归属分析方法,从相对公平和绝对公平角度,评价东中西部城市居民政府医疗机构补助的受益的公平性。结果:东中西部不同经济收入人群门诊、住院和医疗总补助的构成差异均有统计学意义(χ2门诊补助=48.101,P=0.000;χ2住院补助=30.241,P=0.000;χ2医疗总补助=34.628,P=0.000);东中西部城市居民门诊政府补助集中指数分别为0.107、0.081和0.112,中部城市绝对公平性略好于东部和西部;住院政府补助集中指数分别为0.178、0.223和0.218,东部城市绝对公平性略好于西部和中部;东中西部城市居民门诊政府补助Kakwani指数分别为-0.179、-0.214和-0.170,中部城市相对公平性略好于东部和西部,住院政府补助Kakwani指数分别为-0.108、-0.072和-0.064,东部城市相对公平性好于中部和西部。结论:东中西部城市门诊、住院政府医疗服务的相对公平性均较高;不同经济水平居民的门诊政府补助的公平性均好于住院补助。
OBJECTIVE: To evaluate the fairness of subsidies for urban government medical institutions in the eastern, central and western regions. Methods: Based on the survey data of health survey of typical urban residents in eight community health reform programs in 2011, the benefit-attribution analysis method was used to evaluate the fairness of benefits of subsidies for urban government of urban residents in the eastern, central and western regions from the perspective of relative fairness and absolute fairness. Results: There were significant differences in the composition of outpatient, inpatient and total medical benefits among different economic groups in the eastern, central and western regions (χ2 outpatient subsidy = 48.101, P = 0.000; χ2 hospitalization allowance = 30.241, P = 0.000; 34.628, P = 0.000). The concentration index of out-patient government subsidies for urban residents in the eastern, central and western regions were 0.107, 0.081 and 0.112, respectively. The absolute fairness of the central cities was slightly better than that of the eastern and western regions; the concentration indices of inpatient government grants were 0.178, 0.223 and 0.218, The absolute fairness of eastern cities is slightly better than that of western and central cities. The Kakwani index of out-patient government subsidies of eastern, central and western cities is -0.179, -0.214 and -0.170, respectively. The relative fairness of central cities is slightly better than that of east and west. Kakwani index Respectively -0.108, -0.072 and -0.064. The relative fairness of eastern cities is better than that of central and western regions. Conclusion: The relative fairness of outpatient service and in-hospital government medical services in the eastern, central and western cities are higher than that of inpatients in different economic levels.