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目的:研究我国卫生系统绩效的公平性,为我国卫生系统加强提供依据。方法:基于WHO卫生系统绩效评价框架,利用国家卫生服务调查扩点省份数据和相对集中指数方法,从地区、收入、教育等维度研究我国不同地区和省份的卫生系统绩效不平等。结果:我国卫生系统健康状况和满意度方面集中指数一般不超过0.1,而经济风险保护在各个维度的相对集中指数总体在0.2以上,处于相对较高的水平。结论:我国卫生系统绩效健康和满意度方面公平性较好,但是经济风险保护不平等问题突出;卫生系统绩效呈现出弱势人群脆弱性,低收入和受教育水平人群受到健康冲击更严重。国家和地区层面需要更多的关注贫困地区以及弱势人群,给予更多的健康管理和医疗保障支持。
Objective: To study the fairness of the performance of health system in our country and provide the basis for the strengthening of our health system. Methods: Based on WHO Health System Performance Evaluation Framework, using the national health service survey to expand provincial data and relative concentration index, the health system performance inequality in different regions and provinces in China was studied from the dimensions of region, income and education. Results: The concentration index of the health status and satisfaction of our country’s health system generally does not exceed 0.1, while the relative concentration index of economic risk protection in all dimensions is generally above 0.2, which is at a relatively high level. Conclusion: The fairness of health system performance and satisfaction in our country is better, but the problem of unequal economic risk protection is prominent. The performance of health system shows the vulnerability of vulnerable population, and the health impact of population with low income and educational level is more serious. At the national and regional levels, more attention needs to be given to poverty-stricken areas and disadvantaged groups, giving more health management and medical support.