Abstract: Objective　To discuss allocation differences and fairness of communities general practitioners in districts and counties of Beijing from 2011 to 2014.Methods　The number of community general practitioners,and number of resident population in Beijing and 16 districts and counties from 2011 to 2014 were collected.According to different functions of areas in Beijing,they were divided into 4 types of areas:core functions areas of capital（Dongcheng District,Xicheng District）,urban functional expansion areas（Chaoyang District,Fengtai District,Shijingshan District,Haidian District）,new districts of urban development（Fangshan District,Tongzhou District,Shunyi District,Changping District,Daxing District） and ecological conservation development areas（Mentougou District,Huairou District,Pinggu District,Miyun County,Yanqing County）.The allocation differences and fairness of community general practitioners per 10 thousand in each district and county were analyzed by adopting maximum/minimum values（times）,relative difference coefficient,and it was further analyzed by using Theil index．Results　From 2011 to 2014,the number of community general practitioners per 10 thousand in Beijing were 2.76,2.80,2.80 and 2.73 respectively.The maximum/minimum value of the number of community general practitioners per 10 thousand in each district and county increased from 4.03 in 2011 to 4.82 in 2014,the relative difference coefficient increased from 38.5% in 2011 to 41.7% in 2014;the Gini coefficient increased from 0.161 7 in 2011 to 0.178 3 in 2014;the differential index increased from 0.111 8 in 2011 to 0.123 0 in 2014;the overall Theil index increased from 0.019 3 in 2011 to 0.024 0 in 2014,and the inter-area Theil index increased from 0.007 9 in 2011 to 0.011 3 in 2014,while the proportion of inter-area Theil index in the overall Theil index decreased from 59.1% in 2011 to 52.9% in 2014,of which the proportion of new districts of urban development in inter-area Theil index increased from 78.1% in 2011 to 82.7% in 2014.Conclusion　The overall fairness of allocation of community general practitioners in Beijing is good.However,the unfairness of allocation of community general practitioners in each district and county is increasing year by year,and this is mainly caused by the increasing differences between areas,moreover,the allocation of community general practitioners within new districts of urban development is not so good.

Key words: Community health services, General practitioners, Health care rationing

摘要： 目的　探讨2011—2014年北京市各区县社区全科医生配置差异及公平性。方法　收集2011—2014年北京市及其16个区县的社区全科医生数、常住人口数，并按不同功能将其划分为首都功能核心区（东城区、西城区）、城市功能拓展区（朝阳区、丰台区、石景山区、海淀区）、城市发展新区（房山区、通州区、顺义区、昌平区、大兴区）和生态涵养发展区（门头沟区、怀柔区、平谷区、密云县、延庆县）4类地区。采用最大值/最小值（倍数）、相对差异系数、基尼系数、差别指数分析各区县每万人口社区全科医生配置差异及公平性，并采用泰尔指数进一步分析各地区每万人口社区全科医生配置公平性。结果　2011—2014年北京市每万人口社区全科医生数分别为2.76、2.80、2.80、2.73人。各区县每万人口社区全科医生数的最大值/最小值由2011年的4.03增加到2014年的4.82，相对差异系数由2011年的38.5%增加到2014年的41.7%；基尼系数由2011年的0.161 7增加到2014年的0.178 3；差别指数由2011年的0.111 8增加到2014年的0.123 0；总体泰尔指数由2011年的0.019 3增加到2014年的0.024 0，地区间泰尔指数由2011年的0.007 9增加到2014年的0.011 3，而地区内泰尔指数占总体泰尔指数的比例由2011的59.1%降低到2014年的52.9%，其中城市发展新区泰尔指数占地区内泰尔指数的比例由2011年的78.1%增加到2014年的82.7%。结论　北京市社区全科医生配置的总体公平性较好，但各区县社区全科医生配置的不公平性逐年增加，主要是由地区间差距增大引起。另外城市发展新区内部社区全科医生配置的公平性较差。

关键词: 社区卫生服务, 全科医生, 卫生保健公平提供