中国心理卫生杂志

目的:为优化河南省区县级精神卫生资源配置公平性提供参考。方法:设计问卷收集2020年河南省区县级精神卫生机构、医护人员和床位资源数据，运用核密度分析、空间自相关法以及洛伦兹曲线和泰尔指数法，对3类资源进行空间解析和量化评估。结果:采集河南省精神卫生机构128家，按人口分布，每千人分布0.2个机构，配置19.3名医护人员和43.7张床位；按地理面积分布，每百平方千米分布0.1个机构，配置10.3名医护人员和23.2张床位。按人口分布的3类资源的基尼系数与泰尔指数均小于按地理面积分布的同类资源，且仅按人口分布的机构的基尼系数小于0.4,其余均为警戒状态。两种维度下的3类资源均显著呈现“局部集中，整体分散”特征，高密度区均集中于豫北地区，基尼系数及总体泰尔指数均为机构<床位<医护人员，各区域间贡献率均比区域内小，最高达78.8%。结论:河南省精神卫生资源总量不足、空间分布不均衡，尤其在豫北地区及瀍河回族区邻近区县，地理面积配置公平性均低于人口配置，医护人员配置不公平性均最显著，根源在于区域内部差异。

Objective:Toprovide empirical evidence for optimizing the equitable allocation of mental health institutions, medical staff, and bed resources at the district and county levels in Henan Province.Methods:Data on mental health institutions, medical staff, and bed resources at the district and county levels in Henan Province were collected through a self-developed questionnaire in 2020.Kernel density analysis, Spatial auto-correlation method, and Lorenz curve and Theil index method were used to assess the spatial distribution and equity of three types of resources from both population-based and geographic area-based perspectives.Results:A total of 128 mental health facilities in Henan Province were included.Per 1 000 populations, there were 0.2 institutions, equipped with 19.3 medical staff and 43.7 beds.Per 100 square kilometers, there were 0.1 institutions, equipped with 10.3 medical staff and 23.2 beds.The Gini coefficients and Theil index values were consistently lower when calculated on a population basis than on a geographic area basis, with only the population-based institution Gini coefficient falling below the 0.4 threshold.The three types of resources based on population and geographical distribution all exhibited the characteristics of “local concentration and overall dispersion”.The high-density areas were mainly concentrated in northern Henan.The Gini coefficient and overall Theil index values were the smallest for institutions, followed by beds, and the highest for medical staff.Theil index decomposition indicated that intra-regional disparities were the primary source of inequity, with intra-regional contributions reaching up to 78.8%.Conclusion:Mental health resources in Henan Province are insufficient and unevenly distributed.Geographical allocation is less equitable than population-based allocation, particularly in northern Henan and adjacent areas around Chanhe Hui District.The most pronounced inequity is observed in the allocation of medical staff, driven largely by disparities within regions.