Under the process of improving the capacity of primary health services, promoting hierarchical diagnosis and treatment, and realising the integration of medicine and prevention, the state has introduced a series of policies to support the cultivation of general practitioners, and to promote the rational distribution of general practitioners' resources. However, at the present stage, the study on the equilibrium of the distribution of general practitioners is still not comprehensive enough, and lacks the attention to both primary health care and disease prevention.

To set up indicators more comprehensively on the basis of previous studies to evaluate the characteristics and equilibrium of the distribution of general practitioners between provinces in China, and to provide theoretical support for the optimal distribution of general practitioner resources.

We collected data from the 2018-2022 China Health Statistics Yearbook, the 2018-2022 China Statistics Yearbook, and the 2021 China Urban Statistics Yearbook from the websites of the National Health Commission, the National Bureau of Statistics, and offline libraries in April 2023, measured interprovincial general practitioner distribution on an absolute level using five indicators: general practitioners per 10 000 population, general practitioners per 10 square kilometres, the general practitioner-inhabitant disposable income ratio, the general practitioner-primary care institution ratio, and the general practitioner-disease prevention institution ratio, combined with descriptive statistics; The GINI coefficient of the five dimensions of population, area, income, primary health care and disease prevention, combined with the Lorenz curve, were used to preliminarily evaluate the provincial relative distribution gap of general practitioners; Further measured the equilibrium of the distribution of the number of general practitioners among provinces by using the five dimensional DAGUM decomposition GINI coefficient, including inter-group GINI coefficient, intra-group GINI coefficient and inter-group GINI coefficient within each region, combined with the analysis of the agglomeration degree of population and area.

During 2017 to 2021, the number of general practitioners in China had been growing rapidly. In 2021, the average number of general practitioners per 10 000 population was 2.93, the median was 2.80, and the standard deviation was 0.87; The GINI coefficient of the five-year population dimension was (0.195±0.047), the area dimension was (0.608±0.019), the income dimension was (0.401±0.015), the primary health care dimension was (0.318±0.058), and the disease prevention dimension was (0.393±0.033) ; The annual Lorentz curve of the population dimension deviated slightly from the 45° line, the area dimension and income dimension deviated significantly, and the Lorentz curve of the primary health care dimension and disease prevention dimension deviated moderately; In the result of DAGUM decomposition GINI coefficient, the contribution rate of GINI coefficient between groups was (59.863%±8.785%), the gap between groups was the main reason for the overall gap, and the hypervariable density was (25.959%±10.052%), and the gap within each regional group could not be ignored. Further decomposition results showd that within the region the inter-group GINI coefficient in the area dimension of East China and North China were higher, 0.570 and 0.504, respectively, and the inter-group GINI coefficient of the income dimension in North China was higher, 0.413, and the gap was mainly from Beijing, Tianjin, and Shanghai and the other provinces in the region; The results of agglomeration analysis showd that the values of Qinghai, Henan, Anhui, Guangdong and Jilin provinces were closer to the reasonable value 1, the values of other provinces were different, but they were close to 1 except for Tianjin, Shanxi, Inner Mongolia, Fujian, Hubei, Ningxia and Xinjiang provinces.

In absolute terms, the number of general practitioners in China has reached the established development goal. The construction of general practitioners has made remarkable achievements, but the relative number gap between provinces is still large. Although the polarization of agglomeration degree is improving, it still exists. The equilibrium of the distribution of general practitioners needs to be further optimized. We should continue to strengthen the training efforts to promote the growth of the number of general practitioners, At the same time, we should rely on information technology to encourage cross regional assistance and resource sharing.

在提高基层卫生服务能力、推进分级诊疗、实现医防融合的进程下，国家陆续出台了一系列政策支持全科医生的培养，促进全科医生资源合理布局，而现阶段对全科医生分布均衡性的研究仍不够全面，缺少对基层医疗和疾病预防两个方面的关注。

在以往研究的基础上更加全面地设置指标以评价我国省际全科医生的分布特征与均衡性，为全科医生资源优化分布提供理论支持。

研究者于2023年4月自国家卫生健康委员会网站、国家统计局网站以及线下图书馆分别收集2018—2022年《中国卫生健康统计年鉴》、2018—2022年《中国统计年鉴》和2021年《中国城市统计年鉴》的数据，使用每万人全科医生数、每十平方千米全科医生数、全科医生-居民可支配收入比、全科医生-基层医疗卫生机构比、全科医生-疾病预防机构比5项指标，结合描述性统计衡量绝对层面上省际全科医生分布情况；使用人口、面积、收入、基层医疗、疾病预防5个维度的基尼系数，结合洛伦兹曲线衡量省际全科医生在相对层面上的分布差距；使用DAGUM分解基尼系数中的组间基尼系数、组内基尼系数、各区域内部组间基尼系数，结合人口、面积两个方面的集聚度分析进一步衡量省际全科医生分布的均衡性。

2017—2021年，我国全科医生数量在快速增长，2021年每万人口全科医生数均值为2.93人，中位数为2.80人，标准差为0.87；5年内人口维度基尼系数为（0.195±0.047），面积维度为（0.608±0.019），收入维度为（0.401±0.015），基层医疗维度为（0.318±0.058），疾病预防维度为（0.393±0.033）；人口维度各年度洛伦兹曲线偏离45度线幅度较小，面积维度和收入维度偏离幅度较大，基层医疗维度和疾病预防维度洛伦兹曲线偏离程度中等；DAGUM分解基尼系数结果中，组间基尼系数贡献率为（59.863%±8.785%），组间差距是造成总体差距的主要原因，超变密度为（25.959%±10.052%），各区域内部差距不可忽视，进一步分解结果显示，2021年华东和华北地区面积维度区域内组间基尼系数较高，分别为0.570和0.504，华北地区收入维度组间基尼系数较高（0.413），差距主要来源于京津沪与区域内其他省份；集聚度分析结果显示，青海省、河南省、安徽省、广东省和吉林省5个省份数值更接近最优值1，其余省份数值高低不一，除天津市、山西省、内蒙古自治区、福建省、湖北省、宁夏回族自治区、新疆维吾尔自治区7个省份外均在向1靠拢。

我国全科医生数量在绝对层面上已经达到既定发展目标，全科医生建设取得了显著成就，但在相对层面上各省份差距仍然较大，集聚度两极分化现象虽在改善，但依旧存在，全科医生分布的均衡性有待进一步优化，应该继续加大培养力度以促进全科医生数量增长，同时依靠信息技术手段鼓励跨区域协作与资源共享。