摘要
医疗可及性和质量(healthcare access and quality index,HAQ)是反映医疗系统及时、有效地发现、管理、治疗从而避免疾病死亡能力的重要指标.本研究利用2015年全球疾病负担研究结果,比较2015年中国与全球主要国家的HAQ指数差异,同时分析1990~2015年期间中国疾病间、省级行政区间HAQ指数及其变化幅度的差异.2015年中国HAQ指数为74.2分,高出全球平均水平20.5分;中国HAQ指数与其期望值仅相差1.2分,此差距远低于全球平均水平(20.1分).1990~2015年中国在呼吸系统疾病(上呼吸道感染、慢性呼吸系统疾病)、计划免疫性疾病(白喉、百日咳、破伤风和麻疹)、通过常规手术治愈的疾病(阑尾炎和腹股沟、股骨和腹部疝)、孕产妇疾病、缺血性心脏病和医疗副作用表现出较高的HAQ.2015年北京、澳门、上海等9个省级行政区的HAQ指数达到80分以上;西藏、青海、贵州、新疆和云南的HAQ指数最低;且处于高和中高社会人口发展水平的大部分省级行政区,其HAQ指数均高于其相应的期望值.1990~2015年中国HAQ指数增长49.30%,其中长幅最大的省级行政区为新疆、江西、云南和陕西,均超过55%;长幅最小的省级行政区为西藏、香港和澳门.研究表明,1990~2015年间,中国医疗可及性和质量有较大程度的提高,但在不同疾病领域、不同省级行政区表现出的医疗可及性和质量及其改善程度差异较大.
The healthcare access and quality（HAQ） is an important index that reflects health system capacity for timely and effectively detecting, managing, curing and avoiding death from a range of diseases. The purpose of this study is to examine the current status and temporal trend of the healthcare access and quality in China at both national and provincial level. Using the results of global burden of disease study 2015, we compared the HAQ index between China and some other selected countries, at the same time analyzed the differences in HAQ and its temporal trend from 1990 to 2015 both by diseases and by provinces across China. In 2015, the HAQ index of China was 74.2, and 20.5 higher than the global average; the HAQ index was only 1.2 lower than its expectancy in China and this gap was far lower than the global average（20.1）. From 1990 to 2015, in China, the HAQ was higher in respiratory diseases（upper respiratory infections, chronic respiratory disease）, vaccine-preventable diseases（Diphtheria, Whooping cough, Tetanus, Measles）, diseases for which routine surgeries can easily avert mortality（appendicitis, inguinal, femoral, and abdominal hernia）, maternal disorders, Ischaemic heart disease, and adverse effects of medical treatment. In 2015, there were 9 provinces, such as Beijing, Macao, Shanghai and so on, with a HAQ index of 80 or more, whilst the lowest HAQ index was found in Tibet, Qinghai, Guizhou, Xinjiang and Yunnan. In most provinces with highest and relatively higher level of socio-demographic development, the HAQ index was higher than its expectancy. From 1990 to 2015, the HAQ index increased by 49.30%, among which the provinces with the largest increasing were Xinjiang, Jiangxi, Yunnan and Shaanxi and their growth rates were more than 55%. The provinces with the smallest increase in HAQ index were Tibet, Hong Kong and Macao. This study indicated that between 1990 and 2015, the healthcare access and quality in China have been improved markedly, but the gaps remained among diseases and among provinces.
作者
曾新颖
王黎君
殷鹏
刘韫宁
刘江美
由金玲
周脉耕
Xinying Zeng;Lijun Wang;Peng Yin;Yunning Liu;Jiangmei Liu;Jinling You;Maigeng Zhou(National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China)
出处
《科学通报》
EI
CAS
CSCD
北大核心
2018年第25期2631-2640,共10页
Chinese Science Bulletin
