Analysis on urban-rural difference of health resource allocation in maternal and child health institutions in Sichuan province based on Gini coefficient and agglomeration degree_Chinese Journal of Evidence-Based Medicine

Authors：

BO Zhenyan ^1,2,3,4 , JIANG Yuxin ⁵ , ZOU Kun ^1,2,3,4 , LI Hailong ^1,2,3,4 , ZENG Linan ^1,2,3,4 , TANG Yong ⁶ , ZHAO Shaoyang ⁶ ,  JIANG Yongmu ⁶ ,  ZHANG Lingli ^1,2,3,4,7

1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. NMPA Key Laboratory for Technical Research on Drug Products in vitro and in vivo Correlation, Chengdu 610041, P. R. China;
4. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, P. R. China;
5. School of Mathematics, Sichuan University, Chengdu 610041, P. R. China;
6. School of Economics, Sichuan University, Chengdu 610041, P. R. China;
7. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

JIANG Yongmu, Email: Jiangyongmu@163.com; ZHANG Lingli, Email: zhanglingli@scu.edu.cn

Keywords：

Maternal and child health care; Allocation of health care resource; Equity; Gini coefficient; Agglomeration degree

DOI：

10.7507/1672-2531.202401101

Video：

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Objective To analyze and compare the urban-rural difference of health resource allocation of maternal and child health institutions in Sichuan province. Methods Gini coefficient and agglomeration degree was used to analyze the equity of health resource allocation of maternal and child health institutions in Sichuan province. Results The number of maternal and child health institutions per 10 000 population in rural areas was higher than that in urban areas, while the hospital beds and health workers per 10 000 population was lower. In terms of population-based Gini coefficient, the value of three type of health resources of maternal and child health institutions in Sichuan Province were lower than 0.4, indicating a good equity, however, the value of institutions and health workers in urban areas were lower than those in rural areas, the value of hospital beds were higher than those in rural areas. In terms of the difference between HRAD and PAD, there were great differences in the population-based accessibility of health resources of maternal and child health institutions in Sichuan province, relative excess and relative deficiency coexisted in different city (state). Moreover, there were differences in population-based accessibility to health resources of maternal and child health institutions between urban and rural areas in each city (state). Conclusion There are obvious urban-rural and regional differences in health resources allocation of maternal and child health institutions in Sichuan province. Social factors such as population, geographical area and service radius should be comprehensively considered according to the real needs in the planning of rational health resources allocation of maternal and child health institutions.

Citation： BO Zhenyan, JIANG Yuxin, ZOU Kun, LI Hailong, ZENG Linan, TANG Yong, ZHAO Shaoyang, JIANG Yongmu, ZHANG Lingli. Analysis on urban-rural difference of health resource allocation in maternal and child health institutions in Sichuan province based on Gini coefficient and agglomeration degree. Chinese Journal of Evidence-Based Medicine, 2025, 25(1): 42-49. doi: 10.7507/1672-2531.202401101 Copy

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11.	鄭研輝, 郝曉寧, 薄濤, 等. 北京市基層醫療衛生機構資源配置公平性研究. 中國衛生經濟, 2020, 39(7): 46-49.
12.	郭壹凡, 曾志嶸. 基于集聚度和泰爾指數的珠三角九市衛生資源配置公平性分析. 中國衛生統計, 2022, 39(3): 422-425.
13.	劉春雨, 龔超, 薄云鵲, 等. 基于基尼系數和聚集度的天津市衛生資源配置公平性分析. 中國醫院, 2022, 26(9): 32-35.
14.	張濤, 孫立奇, 李書婷, 等. 我國公共衛生資源配置的公平與效率分析—基于HRAD和DEA的研究. 中國衛生政策研究, 2017, 10(9): 57-62.
15.	蘇彬彬, 劉尚君, 盧彥君, 等. 基于集聚度的我國基層衛生人力資源配置評價研究. 中國衛生政策研究, 2021, 14(4): 49-54.
16.	王學義. "全面二孩"四川人口數量及結構變動. 四川黨的建設(城市版), 2016, (1): 43.
17.	孫曉桐, 邵麗娜, 郎穎. 寧夏婦幼保健機構衛生資源配置均衡性研究. 中國生育健康雜志, 2023, 34(6): 532-538.
18.	趙曉山, 王賀, 黃偉康, 等. 廣東省婦幼保健機構衛生資源配置的現狀及公平性研究. 中國社會醫學雜志, 2021, 38(4): 465-468.
19.	張衍萍, 洪陽, 何蕾, 等. 貴州省婦幼保健機構衛生資源配置公平性及預測. 中國預防醫學雜志, 2023, 24(8): 806-813.
20.	趙麗培, 葉貝珠, 邢雨涵, 等. 2012-2020年我國婦幼衛生人力資源配置公平性及空間分布. 衛生軟科學, 2023, 37(10): 62-66, 76.
21.	吳孝蘋, 段占祺, 楊青梅, 等. "二孩政策"后四川省經產婦人口學特點和高齡產婦妊娠與分娩期疾病分布. 中國計劃生育和婦產科, 2019, 11(7): 90-94.
22.	Li HT, Xue M, Hellerstein S, et al. Association of China's universal two child policy with changes in births and birth related health factors: national, descriptive comparative study. BMJ, 2019, 366: l4680.
23.	田甜, 倪潔, 力曉蓉, 等. 2017年四川省婦幼保健機構資源配置現狀調查結果分析. 預防醫學情報雜志, 2019, 35(10): 1134-1138.
24.	李紅娟, 趙艷華, 徐樂. 我國婦幼保健機構衛生資源可及性與公平性研究. 衛生經濟研究, 2023, 40(11): 61-64.
25.	劉曉君, 胡永新, 袁兆康, 等. 江西省醫療服務體系建設現況分析與問題探討. 中國衛生經濟, 2016, 35(3): 56-59.
26.	李揚萩, 張敏, 劉紅. 2012-2016年四川省婦幼保健衛生資源配置公平性與利用效率分析. 醫學與社會, 2019, 32(10): 9-12.
27.	閻園, 楊茜茜, 張翔. 基于集聚度的中國婦幼保健衛生資源配置公平性分析. 中國婦幼保健, 2022, 37(5): 913-918.
28.	李婉, 韓彩欣. 我國西部地區全科醫生配置公平性研究—基于基尼系數和集聚度. 衛生經濟研究, 2020, 37(9): 29-32.

1. Liang J, Li X, Kang C, et al. Maternal mortality ratios in 2852 Chinese counties, 1996-2015, and achievement of millennium development goal 5 in China: a subnational analysis of the global burden of disease study 2016. Lancet, 2019, 393(10168): 241-252.
2. Qiao J, Wang Y, Li X, et al. A Lancet commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China. Lancet, 2021, 397(10293): 2497-2536.
3. 國務院婦女兒童工作委員會. 中國兒童發展狀況國家報告(2003~2004年). 2005.
4. Gao Y, Zhou H, Singh NS, et al. Progress and challenges in maternal health in western China: a countdown to 2015 national case study. Lancet Glob Health, 2017, 5(5): e523-e536.
5. 中華人民共和國中央人民政府. 孕產婦死亡率城鄉差距明顯縮小,我國婦幼健康服務達到新水平. 2019.
6. 劉欣宇, 張宜民, 李妍婷, 等. 我國婦幼保健服務公平性現狀研究. 中國婦幼保健, 2016, 31(12): 2411-2414.
7. 姜威, 姜萍, 朱秋玲. 1995-2014年濟南市孕產婦死亡的城鄉差異性分析. 中國婦幼保健, 2017, 32(22): 5496-5499.
8. 田丹, 何思長, 周明華, 等. 新醫改十年四川省城鄉衛生人力資源公平性及趨勢預測研究. 衛生軟科學, 2021, 35(8): 52-55.
9. 周明華, 譚紅, 何思長. 四川省婦幼保健機構衛生人力資源配置公平性分析. 現代預防醫學, 2021, 48(24): 4452-4456.
10. 毛瑛, 朱斌, 劉錦林, 等. 我國西部地區衛生人力資源配置公平性分析: 基于資源同質性假設. 中國衛生經濟, 2015, 34(7): 31-34.
11. 鄭研輝, 郝曉寧, 薄濤, 等. 北京市基層醫療衛生機構資源配置公平性研究. 中國衛生經濟, 2020, 39(7): 46-49.
12. 郭壹凡, 曾志嶸. 基于集聚度和泰爾指數的珠三角九市衛生資源配置公平性分析. 中國衛生統計, 2022, 39(3): 422-425.
13. 劉春雨, 龔超, 薄云鵲, 等. 基于基尼系數和聚集度的天津市衛生資源配置公平性分析. 中國醫院, 2022, 26(9): 32-35.
14. 張濤, 孫立奇, 李書婷, 等. 我國公共衛生資源配置的公平與效率分析—基于HRAD和DEA的研究. 中國衛生政策研究, 2017, 10(9): 57-62.
15. 蘇彬彬, 劉尚君, 盧彥君, 等. 基于集聚度的我國基層衛生人力資源配置評價研究. 中國衛生政策研究, 2021, 14(4): 49-54.
16. 王學義. "全面二孩"四川人口數量及結構變動. 四川黨的建設(城市版), 2016, (1): 43.
17. 孫曉桐, 邵麗娜, 郎穎. 寧夏婦幼保健機構衛生資源配置均衡性研究. 中國生育健康雜志, 2023, 34(6): 532-538.
18. 趙曉山, 王賀, 黃偉康, 等. 廣東省婦幼保健機構衛生資源配置的現狀及公平性研究. 中國社會醫學雜志, 2021, 38(4): 465-468.
19. 張衍萍, 洪陽, 何蕾, 等. 貴州省婦幼保健機構衛生資源配置公平性及預測. 中國預防醫學雜志, 2023, 24(8): 806-813.
20. 趙麗培, 葉貝珠, 邢雨涵, 等. 2012-2020年我國婦幼衛生人力資源配置公平性及空間分布. 衛生軟科學, 2023, 37(10): 62-66, 76.
21. 吳孝蘋, 段占祺, 楊青梅, 等. "二孩政策"后四川省經產婦人口學特點和高齡產婦妊娠與分娩期疾病分布. 中國計劃生育和婦產科, 2019, 11(7): 90-94.
22. Li HT, Xue M, Hellerstein S, et al. Association of China's universal two child policy with changes in births and birth related health factors: national, descriptive comparative study. BMJ, 2019, 366: l4680.
23. 田甜, 倪潔, 力曉蓉, 等. 2017年四川省婦幼保健機構資源配置現狀調查結果分析. 預防醫學情報雜志, 2019, 35(10): 1134-1138.
24. 李紅娟, 趙艷華, 徐樂. 我國婦幼保健機構衛生資源可及性與公平性研究. 衛生經濟研究, 2023, 40(11): 61-64.
25. 劉曉君, 胡永新, 袁兆康, 等. 江西省醫療服務體系建設現況分析與問題探討. 中國衛生經濟, 2016, 35(3): 56-59.
26. 李揚萩, 張敏, 劉紅. 2012-2016年四川省婦幼保健衛生資源配置公平性與利用效率分析. 醫學與社會, 2019, 32(10): 9-12.
27. 閻園, 楊茜茜, 張翔. 基于集聚度的中國婦幼保健衛生資源配置公平性分析. 中國婦幼保健, 2022, 37(5): 913-918.
28. 李婉, 韓彩欣. 我國西部地區全科醫生配置公平性研究—基于基尼系數和集聚度. 衛生經濟研究, 2020, 37(9): 29-32.

Chinese Journal of Evidence-Based Medicine

Analysis on urban-rural difference of health resource allocation in maternal and child health institutions in Sichuan province based on Gini coefficient and agglomeration degree

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