Regional disparities and influencing factors of high quality medical resources distribution in China

International Journal for Equity in Health

Research

Jing Cao¹  Ge Liu²  Dong Wang²  Zhaoxin Qian³  Lei Yuan³  Dan Yu³ 

[1] Department of Cardiovascular Medicine, Third Xiangya Hospital, Central South University, Changsha, Hunan, China;Xiangya Hospital, Central South University, Changsha, Hunan, China;Xiangya Hospital, Central South University, Changsha, Hunan, China;National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China;

关键词: High quality medical resources;    Regional disparities;    Inequity;    Geographical detector;   

DOI  :  10.1186/s12939-023-01825-6

 received in 2022-09-28, accepted in 2023-01-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWith the gradual increase of residents’ income and the continuous improvement of medical security system, people’s demand for pursuing higher quality and better medical and health services has been released. However, so far little research has been published on China's high quality medical resources (HQMR). This study aims to understand the spatiotemporal variation trend of HQMR from 2006 to 2020, analyze regional disparity of HQMR in 2020, and further explore the main factors influencing the distribution of HQMR in China.MethodsThe study selected Class III level A hospitals (the highest level medical institutions in China) to represent HQMR. Descriptive statistical methods were used to address the changes in the distribution of HQMR from 2006 to 2020. Lorentz curve, Gini coefficient (G), Theil index (T) and High-quality health resource density index (HHRDI) were used to calculate the degree of inequity. The geographical detector method was used to reveal the key factors influencing the distribution of HQMR.ResultsThe total amount of HQMR in China had increased year by year, from 647 Class III level A hospitals in 2006 to 1580 in 2020. In 2020, G for HQMR by population was 0.166, while by geographic area was 0.614. T was consistent with the results for G, and intra-regional contribution rates were higher than inter-regional contribution rates. HHRDI showed that Beijing, Shanghai, and Tianjin had the highest allocated amounts of HQMR. The results of the geographical detector showed that total health costs, government health expenditure, size of resident populations, GDP, number of medical colleges had a significant impact on the spatial distribution of HQMR and the q values were 0.813, 0.781, 0.719, 0.661, 0.492 respectively. There was an interaction between the influencing factors.ConclusionsChina's total HQMR is growing rapidly but is relatively inadequate. The distribution of HQMR by population is better than by geography, and the distribution by geography is less equitable. Population size and geographical area both need to be taken into account when formulating policies, rather than simply increasing the number of HQMR.

【 授权许可】

CC BY   
© The Author(s) 2023

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