Article(id=1324078579591545024, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508217, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1754928000000, receivedDateStr=2025-08-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614533565, onlineDateStr=2026-11-02, pubDate=1767974400000, pubDateStr=2026-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614533565, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614533565, creator=13701087609, updateTime=1793614533565, updator=13701087609, issue=Issue{id=1324078333767594037, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='1767974400000', pubDateStr='2026-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614474956, creator='13701087609', updateTime=1793614571752, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078739914621270, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078739914621271, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=129, endPage=134, ext={EN=ArticleExt(id=1324078580040335553, articleId=1324078579591545024, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To evaluate the fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024,providing a basis for optimizing human resource allocation and enhancing the effectiveness of the health supervision system.

Methods

Based on relevant statistical and supervision data of Yunnan Province from 2020 to 2024, the allocation of health supervisor resources was assessed from three dimensions of current status, fairness, and efficiency, utilizing comprehensive quality scores of health supervisors, the Gini coefficient, and Data Envelopment Analysis (DEA) efficiency scores.

Results

The number of health supervisors in Yunnan Province decreased from 1 762 in 2020 to 1 688 in 2024, while the supervised entities per supervisor increased from 189.78 to 257.25. The comprehensive quality score improved from 6.34 to 6.47, whereas the professional title score decreased by 13.1%. The Gini coefficients for the quantity of health supervisors, calculated based on the permanent resident population and the number of supervised entities, remained below 0.18, indicating a high level of equity. In contrast, the corresponding Gini coefficient for quality was close to the 0.4 warning line. The comprehensive efficiency score decreased initially and then increased over the five years, reaching its lowest point 0.797 in 2022. Scale efficiency was lower than pure technical efficiency each year. Prefectures(cities) exhibited regional differentiation in efficiency, characterized as highly efficient and stable, medium efficiency with fluctuation, or low efficiency with fluctuation, and these patterns were primarily influenced by scale efficiency.

Conclusion

The number of health supervisors in Yunnan Province has decreased, leading to a heavier workload, although their overall quality has improved. The fairness of quantity allocation is good, but the fairness of quality allocation requires improvement. Efficiency fluctuations are mainly attributable to scale efficiency. It is recommended to reform the professional title evaluation system, implement differentiated regional allocation strategies, and strengthen technical empowerment to enhance the overall efficiency and fairness of human resource allocation.

, authors=Yu-xuan ZHANG1, Bo YANG2, Ya-ling MA2, Shi-nan ZHANG2, Chun-ming YI2, Song-lin LI1, Ye-xin YAN1, Jia-rong LI1, Yan-qin LI1, Gui-hua ZHUANG1, Li-rong WANG1, authorsList=Yu-xuan ZHANG, Bo YANG, Ya-ling MA, Shi-nan ZHANG, Chun-ming YI, Song-lin LI, Ye-xin YAN, Jia-rong LI, Yan-qin LI, Gui-hua ZHUANG, Li-rong WANG, authorCompany=null, correspAuthors=Li-rong WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078582162653384, articleId=1324078579591545024, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2020—2024年云南省卫生监督员配置公平性与效率研究, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的

评估云南省卫生监督员配置的公平性与效率,为优化人力资源配置、提升卫生监督体系效能提供依据。

方法

基于2020—2024年云南省相关统计与监督数据,运用卫生监督员综合素质得分、基尼系数和数据包络分析(data envelopment analysis,DEA)效率值,从配置现状、公平性与效率三个维度评估卫生监督员资源配置情况。

结果

云南省卫生监督员数量从2020年的1 762人下降至2024年的1 688人,监管管理相对人从189.78人上升至257.25人;综合素质得分从6.34提升至6.47,但职称得分下降13.1%。基于常住人口和管理相对人计算的卫生监督员数量基尼系数持续低于0.18,处于高度平均水平,相应的素质基尼系数则接近0.4警戒线。综合效率值五年间先降后升,2022年最低为0.797,各年份的规模效率均低于纯技术效率值,各州(市)受规模效率的影响呈现高效稳定、中效波动、低效波动的区域分化。

结论

云南省卫生监督员数量减少,工作负荷加重,但素质有所提升;卫生监督员数量配置公平性良好,但素质配置公平性有待改善;效率波动主要受规模效率影响,建议通过改革职称评审、实施差异化区域配置和强化技术赋能,提升人力资源配置的整体效率与公平性。

, authors=张语轩1, 杨波2, 马亚玲2, 张诗楠2, 易纯明2, 李松林1, 闫晔鑫1, 李佳蓉1, 李燕琴1, 庄贵华1, 王丽荣1, authorsList=张语轩, 杨波, 马亚玲, 张诗楠, 易纯明, 李松林, 闫晔鑫, 李佳蓉, 李燕琴, 庄贵华, 王丽荣, authorCompany=null, correspAuthors=王丽荣, authorNote=

张语轩(2002—),女,硕士在读,研究方向:流行病与卫生统计学

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王丽荣,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=FDn0XL6rNJO291yAnzLwwg==, magXml=jQgSj7zB/xr4azWuhm2Rzw==, pdfUrl=null, pdf=QdxHtXkQoI1Vrlxqry/Ncg==, pdfFileSize=744165, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=qvyXIFSR83neHQ0Lpp/+4w==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=RUjSv4d8GhRfiUnjCo8mSw==, mapNumber=null, fund=null)}, authors=[Author(id=1324078582850519247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324078582942793937, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, authorId=1324078582850519247, language=EN, stringName=Yu-xuan ZHANG, firstName=Yu-xuan, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324078583014097106, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, authorId=1324078582850519247, language=CN, stringName=张语轩, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1.西安交通大学医学部公共卫生学院,陕西 西安 710061, bio={"content":"

张语轩(2002—),女,硕士在读,研究方向:流行病与卫生统计学

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European Journal of Public Health, 2019,29(Supplement_3): 28-35., articleTitle=Public health digitalization in Europe, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324078582561112265, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, xref=1., ext=[AuthorCompanyExt(id=1324078582569500874, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, companyId=1324078582561112265, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China), AuthorCompanyExt(id=1324078582577889483, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, companyId=1324078582561112265, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.西安交通大学医学部公共卫生学院,陕西 西安 710061)]), AuthorCompany(id=1324078582649192652, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, xref=2., ext=[AuthorCompanyExt(id=1324078582657581261, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, companyId=1324078582649192652, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.云南省卫生健康综合监督中心)])], figs=[ArticleFig(id=1324078593827012881, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Figure 1, caption=BCC efficiency values of health supervisors allocation in Yunnan Province (2020—2024), figureFileSmall=y9QDLyiOChw1l/LqqP7yfg==, figureFileBig=qvyXIFSR83neHQ0Lpp/+4w==, tableContent=null), ArticleFig(id=1324078593919287570, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=图1, caption=2020—2024年云南省卫生监督员配置的BCC效率值, figureFileSmall=y9QDLyiOChw1l/LqqP7yfg==, figureFileBig=qvyXIFSR83neHQ0Lpp/+4w==, tableContent=null), ArticleFig(id=1324078594602959123, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Table 1, caption=

Input and output indicator system for the efficiency evaluation of health supervisor allocation

, figureFileSmall=null, figureFileBig=null, tableContent=
指标类型指标名称选择依据
投入指标卫生监督员数量衡量基础人力规模,是履行法定职责的基本保障
卫生监督员综合素质得分人力资本质量的核心度量,反映队伍专业化水平与工作效率潜力
卫生监督机构人员支出反映资本性投入。是评估资源配置经济效率的关键指标
产出指标监督检查户次数衡量日常工作量与执法覆盖范围,体现监督工作的频次与广度
查处案件数反映执法成果与对违法行为的威慑力
双随机案件查处率评估现有抽查机制下发现问题和精准执法的能力
实验室检测监督抽检数体现监督工作的科学性与技术含量,为风险评估与执法提供证据支撑
), ArticleFig(id=1324078594695233812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=表1, caption=

卫生监督员配置效率评价的投入与产出指标体系

, figureFileSmall=null, figureFileBig=null, tableContent=
指标类型指标名称选择依据
投入指标卫生监督员数量衡量基础人力规模,是履行法定职责的基本保障
卫生监督员综合素质得分人力资本质量的核心度量,反映队伍专业化水平与工作效率潜力
卫生监督机构人员支出反映资本性投入。是评估资源配置经济效率的关键指标
产出指标监督检查户次数衡量日常工作量与执法覆盖范围,体现监督工作的频次与广度
查处案件数反映执法成果与对违法行为的威慑力
双随机案件查处率评估现有抽查机制下发现问题和精准执法的能力
实验室检测监督抽检数体现监督工作的科学性与技术含量,为风险评估与执法提供证据支撑
), ArticleFig(id=1324078595022389525, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Table 2, caption=

Allocation of health supervisors in Yunnan Province (2020—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生监督员总数每万人口卫生监督员数每万公顷卫生监督员数每卫生监督员监督管理相对人数卫生监督员学历得分卫生监督员职称得分卫生监督员综合素质得分
20201 7620.360.46189.787.842.676.34
20211 8240.390.48196.337.952.646.41
20221 7960.380.47208.838.032.506.43
20231 7580.370.46233.688.122.426.47
20241 6880.360.44257.258.172.326.47
), ArticleFig(id=1324078595106275606, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=表2, caption=

2020—2024年云南省卫生监督员配置情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生监督员总数每万人口卫生监督员数每万公顷卫生监督员数每卫生监督员监督管理相对人数卫生监督员学历得分卫生监督员职称得分卫生监督员综合素质得分
20201 7620.360.46189.787.842.676.34
20211 8240.390.48196.337.952.646.41
20221 7960.380.47208.838.032.506.43
20231 7580.370.46233.688.122.426.47
20241 6880.360.44257.258.172.326.47
), ArticleFig(id=1324078595865444631, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Table 3, caption=

Gini coefficients of health supervisors allocation in Prefectures (Cities) of Yunnan Province (2020—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生监督员数量卫生监督员素质
常住人口数管理相对人数地域面积人均GDP常住人口数管理相对人数地域面积人均GDP
20200.1590.1790.2930.3200.3770.3330.1970.173
20210.1550.1520.2860.3140.3770.3260.1950.175
20220.1530.1480.2770.3150.3780.3250.1950.174
20230.1440.1590.2690.3110.3770.3300.1950.168
20240.1390.1450.2730.3050.3780.3300.1900.155
), ArticleFig(id=1324078596314235160, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=表3, caption=

2020—2024年云南省各州(市)卫生监督员配置的基尼系数

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)卫生监督员数量卫生监督员素质
常住人口数管理相对人数地域面积人均GDP常住人口数管理相对人数地域面积人均GDP
20200.1590.1790.2930.3200.3770.3330.1970.173
20210.1550.1520.2860.3140.3770.3260.1950.175
20220.1530.1480.2770.3150.3780.3250.1950.174
20230.1440.1590.2690.3110.3770.3300.1950.168
20240.1390.1450.2730.3050.3780.3300.1900.155
), ArticleFig(id=1324078597178261785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Table 4, caption=

Comprehensive efficiency values of health supervisors allocation in Prefectures (Cities) of Yunnan Province (2020—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
2020年2021年2022年2023年2024年均值标准差
高效稳定
昆明1.0001.0001.0001.0001.0001.0000.000
丽江1.0001.0001.0001.0001.0001.0000.000
大理1.0001.0001.0001.0001.0001.0000.000
临沧1.0000.8631.0001.0001.0000.9730.061
红河1.0001.0000.9721.0001.0000.9940.013
怒江1.0001.0000.8391.0001.0000.9680.072
中效波动
曲靖0.9711.0000.9280.8361.0000.9470.069
玉溪0.9951.0001.0000.9170.6360.9100.157
昭通1.0000.8200.8530.9141.0000.9170.083
保山1.0000.8020.7070.6750.8420.8050.128
普洱0.7920.8060.8660.9590.8490.8540.066
楚雄0.8750.6700.7340.6701.0000.7900.144
低效波动
德宏1.0000.8110.3290.5670.7670.6950.256
文山0.5520.6280.7080.6980.7370.6650.075
西双版纳0.6080.6540.4490.7210.6210.6110.100
迪庆0.4610.6890.3730.9990.8490.6740.261
), ArticleFig(id=1324078598839206170, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=表4, caption=

2020—2024年云南省各州(市)卫生监督员配置综合效率值

, figureFileSmall=null, figureFileBig=null, tableContent=
2020年2021年2022年2023年2024年均值标准差
高效稳定
昆明1.0001.0001.0001.0001.0001.0000.000
丽江1.0001.0001.0001.0001.0001.0000.000
大理1.0001.0001.0001.0001.0001.0000.000
临沧1.0000.8631.0001.0001.0000.9730.061
红河1.0001.0000.9721.0001.0000.9940.013
怒江1.0001.0000.8391.0001.0000.9680.072
中效波动
曲靖0.9711.0000.9280.8361.0000.9470.069
玉溪0.9951.0001.0000.9170.6360.9100.157
昭通1.0000.8200.8530.9141.0000.9170.083
保山1.0000.8020.7070.6750.8420.8050.128
普洱0.7920.8060.8660.9590.8490.8540.066
楚雄0.8750.6700.7340.6701.0000.7900.144
低效波动
德宏1.0000.8110.3290.5670.7670.6950.256
文山0.5520.6280.7080.6980.7370.6650.075
西双版纳0.6080.6540.4490.7210.6210.6110.100
迪庆0.4610.6890.3730.9990.8490.6740.261
), ArticleFig(id=1324078599229276443, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=EN, label=Table 5, caption=

BCC values of health supervisors allocation in Prefectures(Cities) of Yunnan Province (2024)

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综合效率规模效率纯技术效率规模报酬
昆明1.0001.0001.000—
曲靖1.0001.0001.000
昭通1.0001.0001.000
丽江1.0001.0001.000
临沧1.0001.0001.000
楚雄1.0001.0001.000
红河1.0001.0001.000
大理1.0001.0001.000
怒江1.0001.0001.000—
玉溪0.6360.6650.956irs
保山0.8420.9420.894irs
普洱0.8490.8491.000irs
文山0.7370.7690.959irs
西双版纳0.6210.6560.947irs
德宏0.7670.7710.995irs
迪庆0.8490.8491.000irs
), ArticleFig(id=1324078599334134044, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078579591545024, language=CN, label=表5, caption=

2024年云南省各州(市)卫生监督员配置的BCC值

, figureFileSmall=null, figureFileBig=null, tableContent=
综合效率规模效率纯技术效率规模报酬
昆明1.0001.0001.000—
曲靖1.0001.0001.000
昭通1.0001.0001.000
丽江1.0001.0001.000
临沧1.0001.0001.000
楚雄1.0001.0001.000
红河1.0001.0001.000
大理1.0001.0001.000
怒江1.0001.0001.000—
玉溪0.6360.6650.956irs
保山0.8420.9420.894irs
普洱0.8490.8491.000irs
文山0.7370.7690.959irs
西双版纳0.6210.6560.947irs
德宏0.7670.7710.995irs
迪庆0.8490.8491.000irs
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2020—2024年云南省卫生监督员配置公平性与效率研究
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张语轩 1 , 杨波 2 , 马亚玲 2 , 张诗楠 2 , 易纯明 2 , 李松林 1 , 闫晔鑫 1 , 李佳蓉 1 , 李燕琴 1 , 庄贵华 1 , 王丽荣 1
现代预防医学 | 卫生政策与管理 2026,53(1): 129-134
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现代预防医学 |卫生政策与管理 2026 , 53 (1) : 129 -134
2020—2024年云南省卫生监督员配置公平性与效率研究
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张语轩1, 杨波2, 马亚玲2, 张诗楠2, 易纯明2, 李松林1, 闫晔鑫1, 李佳蓉1, 李燕琴1, 庄贵华1, 王丽荣1
作者信息
  • 1.西安交通大学医学部公共卫生学院,陕西 西安 710061
  • 2.云南省卫生健康综合监督中心
通讯作者:
王丽荣,E-mail:
作者简介:

张语轩(2002—),女,硕士在读,研究方向:流行病与卫生统计学

Fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024
Yu-xuan ZHANG1, Bo YANG2, Ya-ling MA2, Shi-nan ZHANG2, Chun-ming YI2, Song-lin LI1, Ye-xin YAN1, Jia-rong LI1, Yan-qin LI1, Gui-hua ZHUANG1, Li-rong WANG1
Affiliations
  • School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
出版时间: 2026-01-10 doi: 10.20043/j.cnki.MPM.202508217
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目的

评估云南省卫生监督员配置的公平性与效率,为优化人力资源配置、提升卫生监督体系效能提供依据。

方法

基于2020—2024年云南省相关统计与监督数据,运用卫生监督员综合素质得分、基尼系数和数据包络分析(data envelopment analysis,DEA)效率值,从配置现状、公平性与效率三个维度评估卫生监督员资源配置情况。

结果

云南省卫生监督员数量从2020年的1 762人下降至2024年的1 688人,监管管理相对人从189.78人上升至257.25人;综合素质得分从6.34提升至6.47,但职称得分下降13.1%。基于常住人口和管理相对人计算的卫生监督员数量基尼系数持续低于0.18,处于高度平均水平,相应的素质基尼系数则接近0.4警戒线。综合效率值五年间先降后升,2022年最低为0.797,各年份的规模效率均低于纯技术效率值,各州(市)受规模效率的影响呈现高效稳定、中效波动、低效波动的区域分化。

结论

云南省卫生监督员数量减少,工作负荷加重,但素质有所提升;卫生监督员数量配置公平性良好,但素质配置公平性有待改善;效率波动主要受规模效率影响,建议通过改革职称评审、实施差异化区域配置和强化技术赋能,提升人力资源配置的整体效率与公平性。

卫生监督员  /  资源配置  /  公平性  /  效率  /  基尼系数
Objective

To evaluate the fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024,providing a basis for optimizing human resource allocation and enhancing the effectiveness of the health supervision system.

Methods

Based on relevant statistical and supervision data of Yunnan Province from 2020 to 2024, the allocation of health supervisor resources was assessed from three dimensions of current status, fairness, and efficiency, utilizing comprehensive quality scores of health supervisors, the Gini coefficient, and Data Envelopment Analysis (DEA) efficiency scores.

Results

The number of health supervisors in Yunnan Province decreased from 1 762 in 2020 to 1 688 in 2024, while the supervised entities per supervisor increased from 189.78 to 257.25. The comprehensive quality score improved from 6.34 to 6.47, whereas the professional title score decreased by 13.1%. The Gini coefficients for the quantity of health supervisors, calculated based on the permanent resident population and the number of supervised entities, remained below 0.18, indicating a high level of equity. In contrast, the corresponding Gini coefficient for quality was close to the 0.4 warning line. The comprehensive efficiency score decreased initially and then increased over the five years, reaching its lowest point 0.797 in 2022. Scale efficiency was lower than pure technical efficiency each year. Prefectures(cities) exhibited regional differentiation in efficiency, characterized as highly efficient and stable, medium efficiency with fluctuation, or low efficiency with fluctuation, and these patterns were primarily influenced by scale efficiency.

Conclusion

The number of health supervisors in Yunnan Province has decreased, leading to a heavier workload, although their overall quality has improved. The fairness of quantity allocation is good, but the fairness of quality allocation requires improvement. Efficiency fluctuations are mainly attributable to scale efficiency. It is recommended to reform the professional title evaluation system, implement differentiated regional allocation strategies, and strengthen technical empowerment to enhance the overall efficiency and fairness of human resource allocation.

Health supervisors  /  Resource allocation  /  Equity  /  Efficiency  /  Gini coefficient
张语轩, 杨波, 马亚玲, 张诗楠, 易纯明, 李松林, 闫晔鑫, 李佳蓉, 李燕琴, 庄贵华, 王丽荣. 2020—2024年云南省卫生监督员配置公平性与效率研究. 现代预防医学, 2026 , 53 (1) : 129 -134 . DOI: 10.20043/j.cnki.MPM.202508217
Yu-xuan ZHANG, Bo YANG, Ya-ling MA, Shi-nan ZHANG, Chun-ming YI, Song-lin LI, Ye-xin YAN, Jia-rong LI, Yan-qin LI, Gui-hua ZHUANG, Li-rong WANG. Fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024[J]. Modern Preventive Medicine, 2026 , 53 (1) : 129 -134 . DOI: 10.20043/j.cnki.MPM.202508217
卫生监督员作为贯彻卫生法律法规、维护公共卫生秩序的关键执法力量,其人力资源配置的公平性与效率直接关乎国家公共卫生治理体系的现代化水平[1]。全球卫生监督队伍普遍面临结构老化、流失率高与激励不足等挑战[2]。在我国,卫生监督人力资源同样总量不足,且在机构改革后数量呈下降趋势,远未达到国家配置标准[3];其空间分布亦不均衡,呈现出在华北、西北地区集聚,而西南地区成为配置“洼地”的失衡格局[4]。云南省作为西南典型省份,地理环境复杂、经济发展相对滞后,卫生监督工作挑战尤为突出。然而,现有研究多集中于全国或东部发达省份,对云南这类欠发达省份缺乏基于公平与效率双重视角的系统分析。基于此,本研究综合运用基尼系数和数据包络分析(data envelopment analysis,DEA),旨在评估云南省卫生监督员资源配置的公平性与效率,以期为优化其人力资源配置、推动当地卫生监督工作高质量发展提供实证依据。
本研究选取2020—2024年云南省卫生监督相关数据进行分析,此时段能有效反映后疫情时代卫生监督体系的变化与挑战,并与“十四五”规划周期基本吻合,具有重要的现实与政策意义。五年的连续数据也有利于观测资源配置的趋势,避免短期波动干扰。2020—2024年云南省卫生监督员数量、学历、职称、卫生监督机构人员支出、双随机案件查处率来自国家卫生健康监督信息报告系统;监督检查户次数、查处案件数、实验室检测监督抽检数来自云南省卫生健康执法监督综合管理平台;云南省各州(市)常住人口数、辖区面积和人均国内生产总值(per capita gross domestic product,GDP)数据来自2020—2024年《云南统计年鉴》。
使用 Excel 2019 建立数据库,清洗整理原始数据。使用卫生监督员综合素质得分评估卫生监督员综合素质,基尼系数评估卫生监督员配置的公平性,BCC(banker-charnes-cooper model,BCC)效率值评估卫生监督员配置的效率。使用Excel 2019计算卫生监督员综合素质得分和基尼系数,DEAP 2.1计算BCC效率值。
采用人才当量法计算卫生督员综合素质得分,选取学历(反映知识储备)和职称(反映专业能力)作为评价维度,计算公式如下:
权重系数(α为学历权重,取0.71;β为职称权重,取0.29)源于卫生人力素质评价的经典研究,由德尔菲法确定,其依据在于学历是比职称更为客观的素质衡量指标,后续又被多项相关研究采纳和应用,具有公认的合理性和可操作性[5]。式中,N为总人数;ni为学历i的人数;Si为学历i的得分(硕士及以上12分、本科9分、大专6分、中专及中技3分、高中技校1分、初中以下0分);nj为职称j的人数;Tj为职称j的得分(正高20分、副高15分、中级10分、助理师级5分、士级2分、待聘1分)。
分别用常住人口数、辖区面积、管理相对人数、人均GDP四个指标计算卫生监督员数量或素质两个维度的基尼系数,计算公式如下:
Gwy为用w指标计算出的y维度基尼系数;n为州(市)数量;i为各州(市)平均资源拥有量由小到大的排序号;wi为各州(市)指标w占全省总量的百分比;yi为各州(市)维度w占全省总量的百分比;vi为到第i个州(市)维度y的累积值占全省总数量百分比[6]。
根据国际公认标准,基尼系数在0.2以下表明配置处于高度平均状态,0.3以下为相对平均,0.4以下为比较合理,0.4及以上为差距偏大,0.5及以上表明资源配置出现两极分化,国际公认警戒线为0.4。
参考以往文献的研究,结合本研究的目标和卫生监督执法工作的职能特点,确定投入产出指标[7]。以卫生监督员数量、卫生监督员综合素质得分、卫生监督机构人员支出为投入指标,以双随机案件查处率、监督检查户次数、查处案件数、实验室检测监督抽检数为产出指标[8]。这些指标共同构成了一个多维度、全方面的卫生监督员配置效率评价体系。见表1。
在模型选择上,本研究采用DEA法中的BCC模型,该模型放松了CCR模型(charnes-cooper-rhodes,CCR)关于“规模报酬不变”的假设,更符合云南省各州(市)经济社会发展水平不一、卫生监督资源投入规模存在差异的实际情况;其次,BCC模型能够将综合效率分解为纯技术效率和规模效率[7]:综合效率是对卫生监督员配置能力、资源使用效率等多方面能力的综合考量;纯技术效率衡量管理与技术水平的高低;规模效率反映实际规模与最优规模之间的差距;规模报酬表示当所有生产要素按相同比例增加时,产出增加的比例[9]。这种分解有助于甄别效率损失是源于管理和技术水平不足,还是源于资源投入规模与当地实际需求不匹配。云南省的效率用各州(市)效率的平均值来表示。所有效率值取值范围均在0到1之间,1为最优。
2020—2024年,云南省卫生监督员数量配置总体呈下降趋势,卫生监督员总数、每万人口卫生监督员数、每万公顷卫生监督员数在2021年有个小幅度上升,分别达到1 824、0.39、0.46,之后逐年下降,到2024年分别降至1 688、0.36、0.44;每卫生监督员监管管理相对人数则从2020年的189.78逐年上升到了2024年的257.25;卫生监督员素质配置总体呈上升趋势,学历得分和综合素质得分从2020年的7.84和6.34逐年上升到2024年的8.17和6.47,但职称得分从2020年的2.67逐年下降到了2024年的2.32。见表2。
由表3可见,2020—2024年云南省卫生监督员数量配置的基尼系数整体呈下降趋势;常住人口和管理相对人基尼系数始终低于0.18,处于高度平均状态并持续优化;地域面积基尼系数在0.27~0.29区间小幅波动,整体稳定在相对平均状态;而人均GDP基尼系数则从2020年的0.320逐步降至2024年的0.305,由比较合理区间持续向相对平均区间靠拢。
卫生监督员素质配置的基尼系数整体保持稳定,常住人口基尼系数五年间稳定在0.377~0.378的高位,管理相对人基尼系数在0.325~0.333区间小幅波动,两者均处于比较合理区间的中上限且未见改善趋势。相较之下,地域面积基尼系数始终低于0.200,人均GDP维度的系数则从0.173降至2024年的0.155,两者均稳定处于高度平均状态。见表3。
2020—2024年云南省卫生监督员配置综合效率值、规模效率值和纯技术效率值从2020年的0.891、0.897、0.990 下降至2022年的0.797、0.816、0.973,之后又回升至2024年的0.894、0.906、0.984;各年份的综合效率值均小于0.900;各年份的规模效率值均低于纯技术效率值,纯技术效率值比较稳定,规模效率值波动较大。见图1。
2020—2024年云南省卫生监督员配置的综合效率值不同。昆明、丽江等州(市)五年综合效率平均值均大于0.950,标准差均小于0.075,呈高效稳定状态;曲靖、玉溪等州(市)五年综合效率平均值均大于0.750,除曲靖、普洱外标准差均大于0.075,呈中效波动状态;德宏、文山等州(市)五年综合效率平均值均小于0.700,标准差均大于或等于0.075,呈低效波动状态。见表4。
2024年云南省16个州(市)中,9个州(市)综合效率值为1.000,规模报酬不变,其余7个州(市)综合效率值小于1.000,均处于规模报酬递增状态。见表5。
云南省卫生监督员总数五年间下降4.2%,每万人口监督员数(0.36~0.39)远低于国家提出的最低标准(1~1.5名)[10],且呈逐年下降趋势,但每监督员监管管理相对人数却从2020年的189.78个上升至2024年的257.25个,远超2020年全国平均水平(117.75个)[11],工作负荷持续加重。
2021年全国卫生技术人员研究生学历占比为4.00%[12]。2020—2024年,云南省卫生监督员综合素质逐年提升,硕士学历人员数量增长了59.3%,占比也从2.10%上升到了3.44%。云南省卫生监督员学历得分上升明显,职称得分却下降了13.1%,存在职称晋升受阻现象。高学历新人可能因职称评审年限久、高级岗位比例少等因素,积压在初级职称岗位,影响了专业能力的及时认定和发挥。工作负荷的加重与职称激励的缺失,使得通过改革评审机制以提升工作效能的需求尤为迫切。
基于常住人口和管理相对人计算的云南省卫生监督员数量基尼系数持续处于高度平均水平,监督员数量在满足人口需求和监管对象覆盖方面的分布公平性较好。王鑫峰等[4]发现2014—2019年,华东地区卫生监督人力资源集聚度均值高达2.79,而西南地区只有0.44,西南地区在按地域面积配置方面公平性明显不足。本研究发现作为西南地区代表省份,云南省卫生监督员人数按地域面积计算的基尼系数持续稳定在相对平均,表现较好。郭丽芳等[13]发现,2013—2017年,全国近半数省份卫生监督数量配置受经济水平影响较大,东部发达地区的卫生监督员集聚度远高于中西部地区。云南省按人均GDP计算的卫生监督员数量基尼系数虽然处于比较合理水平,但逐年优化并逐渐接近相对平均水平。
云南省基于常住人口和管理相对人计算的卫生监督员素质配置的公平性五年间始终处于比较合理区间的中上限,接近0.4的警戒线,提示高素质人力资源仍集中在人口密集、监管对象众多、职业发展机会更优的地区。这种数量均衡而素质失衡的配置格局,反映了在实现基本覆盖之后,提升人力资源质量分布的均衡性已成为云南省卫生监督体系建设面临的关键挑战。
朱依曦等[14]通过分析2013—2020年全国公共卫生相关数据,发现我国公共卫生资源配置效率偏低,主要受限于规模效率而非技术效率。2020—2024年,云南省卫生监督员配置的综合效率呈现先降后升的趋势,这种波动也主要源于规模效率的变化,提示可以通过提高规模效率来提高综合效率。云南省2022年综合效率降至最低点,可能与突发公共卫生事件后期监管任务量增加,人均监管负担加重有关[15]。
云南省卫生监督效率呈现高效稳定、中效波动、低效波动的区域分化,特别是德宏、迪庆等州(市)长期处于低效波动且规模报酬递增状态。这一结果表明,其效率损失的主要原因是资源投入的规模与当地监管需求不匹配,从经济学视角看,在此类地区增加单位资源投入,将带来产出水平的更高比例提升,资源配置的边际效益十分显著。基于本研究的DEA分析结果,并借鉴公共部门资源配置的相关理论,针对德宏、迪庆等规模效率不足地区,优化配置应聚焦于突破规模瓶颈。
优化云南省卫生监督员配置是一项系统工程,需从微观激励、中观配置与宏观赋能三个维度协同发力。基于本研究结果,特提出以下针对性建议:
第一,改革职称评审,激活高学历人才潜能。针对职称晋升受阻的问题,关键在于设立反映卫生监督实践特性的评价标准。建议将监督检查频次、案件查处质量、突发公卫事件应对贡献等关键绩效指标量化纳入评审,并拓宽“职称晋升与岗位聘任”相结合的职业发展通道,推动评价导向从重论文资历向重实绩能力转变。
第二,实施差异配置,提升规模与素质公平。针对“素质配置公平性接近警戒线”和“部分州市规模效率低下”的问题,应构建以需求为导向的动态配置机制。在编制核定、人才引进与资源投放时,需重点考量管理相对人数量与复杂度、地理可达性及边境口岸等特殊公共卫生风险因素。同时,大力推行智力资源的柔性共享,通过组建专家库、开展跨区域协同执法与对口支援以及人才流动弥补边远地区的高素质人力短缺[16]。
第三,强化技术赋能,突破资源规模约束。针对德宏、迪庆等低效波动且规模报酬递增地区,在编制增长受限的现实条件下,技术应用是突破人力资源刚性约束、提升规模效率的关键杠杆[17]。建议优先为上述低效波动地区配置智慧卫监工具,如移动执法终端、远程在线监测设备、大数据风险预警平台等,通过提升单兵监管能力、扩大有效监管覆盖范围,在现有人员编制总量约束下,实现整体监管效能的跃升。

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2026年第53卷第1期
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doi: 10.20043/j.cnki.MPM.202508217
  • 接收时间:2025-08-12
  • 首发时间:2026-11-02
  • 出版时间:2026-01-10
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  • 收稿日期:2025-08-12
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    1.西安交通大学医学部公共卫生学院,陕西 西安 710061
    2.云南省卫生健康综合监督中心

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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