| 引用本文：王志成, 郭岩.中国县级医疗卫生服务地理可及性的公平性分析[J].中国卫生政策研究,2019,12(9):60-65 |
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| 中国县级医疗卫生服务地理可及性的公平性分析 |
| 投稿时间：2019-04-09 修订日期：2019-07-11 PDF全文浏览 HTML全文浏览 |
| 王志成, 郭岩 |
| 北京大学公共卫生学院 北京 100191 |
| 摘要:目的：建立中国县级层面的地区贫困指数以分析中国医疗卫生服务地理可及性的公平性。方法：采用主成分分析方法提取县级不同维度贫困指标的第一主成分得分，对其标准化后作为县级地区贫困指数。采用最小二乘法分析地区贫困和医疗卫生服务地理可及性的关系。结果：按照地区贫困指数分组，居住在最贫困20%地区的居民平均到最近医疗点的距离和时间分别是居住在最不贫困20%地区居民的2.60倍和2.25倍，存在显著的不公平性。回归分析结果显示，地区贫困指数每增加一个单位，到最近医疗点距离和时间分别增加22.1%和16.6%。结论：中国县级医疗卫生服务地理可及性随着地区贫困程度加深而恶化。 |
| 关键词:地区贫困指数 医疗卫生服务 地理可及性 健康公平 逆向照顾法则 |
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| The equity analysis ofthe county-level geographic accessibility of healthcare services in China |
| WANG Zhi-cheng, GUO Yan |
| School of Public Health, Peking University, Beijing 100191, China |
| Abstract:Objective:To establish an area deprivation index at the county-level and analyze the equity of geographic accessibility of medical services in China. Methods:The principal component analysis method was used to extract the first principal component of county-level deprivation indicators, and the standardized first principal component was defined as the county-level Area Deprivation Index (ADI). The area deprivation and geographic accessibility of healthcare services were analyzed using the ordinary square regression model. Results:According to county-level ADI, the average distance and time to the nearest medical service center/institution were 2.60 times and 2.25 times longer for residents living in the most 20% deprived areas than for those living in the least 20% deprived areas, which indicated a significant imbalance. The results of the regression analysis showed that the distance and time to the nearest healthcare service center/institution increased by 22.1% and 16.6% respectively as the area deprivation index increased by 1 unit. Conclusions:County-level geographic accessibility of healthcare services worsens proportionally to the decrease in area deprivation in China. |
| Key words:Area deprivation index Healthcare services Geographic accessibility Health equity Inverse care law |
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