广西医学

目的分析2020年和2023年广西精神卫生资源配置公平性及利用效率现状，为广西优化配置精神卫生资源及利用效率提供循证依据。方法采用洛伦兹曲线、基尼系数和泰尔指数从人口和地理维度评价广西精神卫生资源配置的公平性，并利用数据包络分析（DEA）评估广西精神卫生资源的利用效率。结果 2023年广西精神卫生资源拥有量较2020年升高；2020年、2023年，广西精神卫生资源按人口配置的洛伦兹曲线均较按地理配置的洛伦兹曲线弯曲度小。人口维度上，2020年及2023年精神科医师、精神科护士、精神科实际开放床位的基尼系数均<0.2，心理咨询师/治疗师的基尼系数分别为0.515 5、0.365 8；地理维度上，2020年及2023年精神科医生、精神科护士的基尼系数均在0.3~0.4之间，精神科实际开放床位的基尼系数分别为0.426 8、0.411 4，心理咨询师/治疗师的基尼系数分别为0.594 0、0.482 1。2020年及2023年，广西各项精神卫生资源按人口维度计算的基尼系数和总泰尔指数均低于按地理维度计算的基尼系数和总泰尔指数，且泰尔指数贡献率多表现为组内大于组间；心理咨询师/治疗师无论是按人口维度计算还是按地理维度计算，总泰尔指数均>0.1，且2020年总泰尔指数均高于2023年。2020年和2023年广西精神卫生资源综合效率分别为82.9%、84.3%，均处于较低水平。结论 2023年广西各类精神卫生资源总量及配置公平性较2020年有所提高，按人口维度配置的公平性优于按地理维度，但在人口和地理维度上仍存在配置不公平现象，且整体利用效率较低，其中，心理咨询师/治疗师及精神科实际开放床位的分布不均衡问题尤为突出。

Objective To analyze the equity in allocation and utilization efficiency of mental health resources in Guangxi in 2020 and 2023, providing an evidence⁃based reference for optimizing the allocation and utilization efficiency of these resources in Guangxi. Methods The Lorenz curve, Gini coefficient, and Theil index were used to evaluate the equity of mental health resource allocation in Guangxi from demographic and geographical dimensions. Data Envelopment Analysis (DEA) was employed to assess the utilization efficiency of mental health resources in Guangxi. Results The total amount of mental health resources in Guangxi in 2023 was higher than that in 2020. In both 2020 and 2023, the Lorenz curves for mental health resource allocation based on the population dimension were less curved than those based on the geographical dimension. From the population dimension, the Gini coefficients for psychiatrists, psychiatric nurses, and actually open psychiatric beds in both 2020 and 2023 were all below 0.2, while the Gini coefficients for psychological counselors/therapists were 0.5155 and 0.3658, respectively. From the geographical dimension, the Gini coefficients for psychiatrists and psychiatric nurses in both years were between 0.3 and 0.4, the Gini coefficients for actually open psychiatric beds were 0.4268 and 0.4114, respectively, and the Gini coefficients for psychological counselors/therapists were 0.5940 and 0.4821, respectively. In both 2020 and 2023, the Gini coefficients and total Theil indices calculated for various mental health resources based on the population dimension were lower than those calculated based on the geographical dimension. The contribution rates of the Theil index mostly indicated that intra⁃group disparity was greater than inter⁃group disparity. The total Theil indices for psychological counselors/therapists, whether calculated by population or geographical dimension, were all greater than 0.1, and the total Theil indices in 2020 were higher than those in 2023. The comprehensive efficiency of mental health resources in Guangxi were 82.9% in 2020 and 84.3% in 2023, both at relatively low levels. Conclusion By 2023, the total amount and allocation equity of various mental health resources in Guangxi had improved compared to 2020. Equity based on the population dimension was better than that based on the geographical dimension. However, inequities in allocation still existed across both dimensions, and the overall utilization efficiency remained low. The uneven distribution of psychological counselors/therapists and actually open psychiatric beds was particularly prominent.