Equity in the distribution of CT and MRI in China: a panel analysis

International Journal for Equity in Health

Research

Da He¹  Yingyao Chen¹  Hao Yu² 

[1] Department of Hospital Management, School of Public Health, National Key Lab of Health Technology Assessment, Fudan University, 200032, Shanghai, P. R.China;RAND Corporation, Pittsburgh, USA;

关键词: High technology medical equipment;    Equity;    Distribution;    Financing;    Lorenz curve;    Gini coefficients;   

DOI  :  10.1186/1475-9276-12-39

 received in 2013-03-03, accepted in 2013-05-17,  发布年份 2013

来源: Springer

【 摘 要 】

IntroductionChina is facing a daunting challenge to health equity in the context of rapid economic development. This study adds to the literature by examining equity in the distribution of high-technology medical equipment, such as CT and MRI, in China.MethodsA panel analysis was conducted with information about four study sites in 2006 and 2009. The four provincial-level study sites included Shanghai, Zhejiang, Shaanxi, and Hunan, representing different geographical, economic, and medical technology levels in China. A random sample of 71 hospitals was selected from the four sites. Data were collected through questionnaire surveys. Equity status was assessed in terms of CT and MRI numbers, characteristics of machine, and financing sources. The assessment was conducted at multiple levels, including international, provincial, city, and hospital level. In addition to comparison among the study sites, the sample was compared with OECD countries in CT and MRI distributions.ResultsChina had lower numbers of CTs and MRIs per million population in 2009 than most of the selected OECD countries while the increases in its CT and MRI numbers from 2006 to 2009 were higher than most of the OECD countries. The equity status of CT distribution remained at low inequality level in both 2006 and 2009 while the equity status of MRI distribution improved from high inequality in 2006 to moderate inequality in 2009. Despite the equity improvement, the distributions of CTs and MRIs were significantly positively correlated with economic development level across all cities in the four study sites in either 2006 or 2009. Our analysis also revealed that Shanghai, the study site with the highest level of economic development, had more advanced CT and MRI machine, more imported CTs and MRIs, and higher government subsidies on these two types of equipment.ConclusionsThe number of CTs and MRIs increased considerably in China from 2006 to 2009. The equity status of CTs was better than that of MRIs although the equity status in MRI distribution got improved from 2006 to 2009. Still considerable inequality exists in terms of characteristics and financing of CTs and MRIs.

【 授权许可】

Unknown   
© He et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.