The primary care facilities in a region play a vital role in maintaining the health of the local residents as the gatekeeper. At present, there is a lack of research on the allocation of primary care resources in Tibet, a remote autonomous region in northwestern China.

To analyze the current situation and equity of the allocation of primary care resources in Tibet, to provide a scientific basis for optimizing the allocation of primary care resources in Tibet.

Data used in this study were from six volumes (2015—2020) of Tibetan Health Statistics Yearbook and China Health Statistics Yearbook, as well as the human resource information in the Primary Care Direct Reporting System of Tibet Health Commission from 2015 to 2020. Descriptive analysis was used to analyze the allocation of primary care resources in Tibet from 2015 to 2020. Gini coefficient and concentration index were used to evaluate the equity of primary care resource allocation in Tibet in 2020.

The number of beds in primary hospitals in Tibet increased from 3 393 in 2015 to 3 867 in 2020. The number of (assistant) practicing physicians per 1 000 people increased from 0.37 in 2015 to 0.61 in 2020. The utilization rate of beds in primary hospitals decreased from 30.9% in 2015 to 11.5% in 2020. The daily visits per primary care physician decreased from 13.80 in 2015 to 9.95 in 2020. The daily number of hospital bed days of care per primary care physician decreased from 0.44 in 2015 to 0.10 in 2020. In 2020, the Gini coefficients of health resources allocated in primary hospitals according to population in Tibet were greater than 0.3, which were better than those allocated according to geography. The difference in the concentration degree between number of beds, number of health technicians, number of (assistant) practicing physicians or number of registered nurses and population, was -6.93, -4.50, -2.50, -6.15, respectively, in Lhasa, and 0.05, -0.21, -0.80, -0.22, respectively, in Changdu, and -0.88, 0.10, 0.47, -0.05, respectively, in Shannan, but was all greater than 0 in other cities.

The primary health workers in Tibet showed a trend of "low growth in number, low capability and low efficiency". It is suggested to pay attention to regional characteristics to improve the allocation standards of primary care resources, promote the equity of the allocation of primary care resources based on geographical classification, reform the employment mechanism and human resource management system in primary care, innovate the system and mechanism of aiding Tibet and establish a new model of financial investment at the primary level.

基层医疗卫生机构是维护当地居民健康的"守门员"，发挥着不可或缺的作用。西藏自治区位于我国西北部，地处偏远地区，目前缺乏对西藏地区基层卫生资源配置的研究。

分析西藏自治区基层卫生资源配置现状及公平性，为优化西藏地区基层卫生资源配置提供科学依据。

本研究数据来源于2015—2020年的《西藏卫生统计年鉴》和《中国卫生统计年鉴》，并从西藏自治区健康委员会基层卫生网络直报系统获取2015—2020年西藏自治区基层卫生的人力数据。描述性分析2015—2020年西藏地区基层卫生资源配置，并利用基尼系数和集聚度评价2020年西藏地区基层卫生资源配置公平性。

2015—2020年，西藏自治区基层床位数由3 393张上升至3 867张，每千人口执业（助理）医师数由0.37人上升至0.61人，基层病床使用率由30.9%下降至11.5%，基层医师日均担负诊疗人次由13.80人次降至9.95人次，医师日均担负诊疗床日由0.44 d下降至0.10 d。2020年，西藏自治区基层卫生资源按人口分布配置的基尼系数均大于0.3，优于按地理面积配置的基尼系数；从床位数、卫生技术人员数、执业（助理）医师数及注册护士数的卫生资源与人口集聚度差值看，拉萨市分别为-6.93、-4.50、-2.50、-6.15，昌都市分别为0.05、-0.21、-0.80、-0.22，山南市为-0.88、0.10、0.47、-0.05，其余地级市卫生资源与人口集聚度差值均大于0。

西藏地区基层卫生人员呈现"低增长、低质量、低效率"趋势。建议重视地域特征，完善基层卫生资源配置标准；依托地理分级标准，促进基层卫生资源配置的公平性；打破基层用人机制，改革卫生人力资源管理制度；创新援藏体制机制，建立基层财政投入新模式。