Enhong Dong1,2, Jie Xu3, Xiaoting Sun4, Ting Xu1, Lufa Zhang5, Tao Wang6,7. 1. School of Nursing and Health Management, Shanghai University of Medicine & Health Science, 279 Zhouzhu Road, Pudong New District, Shanghai, 201318, China. 2. School of Media and Communication, Shanghai Jiao Tong University, Shanghai, 200240, China. 3. Emergency Department, Dezhou People's Hospital, Dezhou, 253003, Shandong Province, China. 4. Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, 200072, China. 5. School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, 200030, China. zhanglf@sjtu.edu.cn. 6. Department of Orthopaedics and Traumatology, Shanghai East Hospital Tongji University School of Medicine, Shanghai, 200127, China. 18521316637@163.com. 7. College of Arts and Media, Tongji University, Shanghai, 200092, China. 18521316637@163.com.
Abstract
BACKGROUND: The distribution of health-care resources is foundational to achieving fairness and having access to health service. China and its local Shanghai's government have implemented measures to allocate health-care resources with the equity as one of the major goals since 2009-health-care reform. The aim of this study was to analyze differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce in Shanghai over 7 years. METHODS: The study was conducted using 2010-2016 data to analyze health-resource allocation on institutions, beds, and workforce in Shanghai, China. The annual growth rate (AGR) was used to evaluate the time trends of health-care resource from 2010 to 2016, and Theil index was calculated to measure inequality of five indicators of health-care resource allocation during this study period. RESULTS: All quantities of health-care resources per 1000 people increased across Shanghai districts from 2010 to 2016. Compared with suburban districts, the central districts had higher ratios on five health-care resource indicators, and faster average growth in the bed and nurse indicator. The Theil of the indicators, except for doctors in hospitals, all exhibited downward time trends. CONCLUSIONS: Regional difference between urban and rural areas and inequality between institution and workforce, especially for doctors, still existed. Some targeted measures including but not limited to income raising, facilitation of transportation conditions, investment of more fiscal funds, enhancement of health-care service provision for rural residents should be fully considered to narrow resource distribution gap between urban and rural districts and mitigate the inequality of health-care resource allocation.
BACKGROUND: The distribution of health-care resources is foundational to achieving fairness and having access to health service. China and its local Shanghai's government have implemented measures to allocate health-care resources with the equity as one of the major goals since 2009-health-care reform. The aim of this study was to analyze differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce in Shanghai over 7 years. METHODS: The study was conducted using 2010-2016 data to analyze health-resource allocation on institutions, beds, and workforce in Shanghai, China. The annual growth rate (AGR) was used to evaluate the time trends of health-care resource from 2010 to 2016, and Theil index was calculated to measure inequality of five indicators of health-care resource allocation during this study period. RESULTS: All quantities of health-care resources per 1000 people increased across Shanghai districts from 2010 to 2016. Compared with suburban districts, the central districts had higher ratios on five health-care resource indicators, and faster average growth in the bed and nurse indicator. The Theil of the indicators, except for doctors in hospitals, all exhibited downward time trends. CONCLUSIONS: Regional difference between urban and rural areas and inequality between institution and workforce, especially for doctors, still existed. Some targeted measures including but not limited to income raising, facilitation of transportation conditions, investment of more fiscal funds, enhancement of health-care service provision for rural residents should be fully considered to narrow resource distribution gap between urban and rural districts and mitigate the inequality of health-care resource allocation.
Entities:
Keywords:
Central districts; Health-care resources; Inequality; Regional difference; Suburban districts
Authors: Jianwei Shi; Lan Tang; Limei Jing; Jinsong Geng; Rui Liu; Li Luo; Ning Chen; Qian Liu; Xin Gong; Xiaojie Bo; Yan Yang; Zhaoxin Wang Journal: BMC Public Health Date: 2019-07-31 Impact factor: 3.295