Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

M. Rezaee, Mohamad Azmal, Farhad Lotfi, H. Omranikhoo
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Abstract

Background: Equity in access to health resources is a fundamental goal of health systems worldwide. Objectives: This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province. Methods: This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18. Results: The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels. Conclusions: Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.
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伊朗卫生资源分配不平等趋势调查:布什尔省案例研究
背景:公平获取卫生资源是全球卫生系统的基本目标。研究目的本研究旨在评估布什尔省提供医疗服务所需的基本医疗资源的分布情况。研究方法这项横断面研究的时间跨度为十年,采用了几种公认的医疗资源分配公平性和平等性指数,包括基尼系数、集中指数、横向不公平、罗宾汉指数、泰尔指数、阿特金森指数和量纲比。这些指数的计算基于人口水平和拟议的资源分配模型(PRAM),使用的是 Excel 软件 2018 和 Stata 版本 18。结果研究结果表明,所有受检医疗资源的分配都存在一定程度的不平等,其中特殊病床的不平等程度远高于其他病床。所研究的指数的敏感性在不同的资源分配中各不相同。此外,在所有研究的资源中,不平等程度普遍呈下降趋势。PRAM 的结果表明,采用不同的资源分配方法可以显著降低不平等程度。结论:尽管医疗资源分配的不平等程度呈下降趋势,但显著的差距依然存在。改变传统的地域分配制度,有助于实现医疗保健的公平和平等。这种改变还可以降低医疗系统的相关成本。
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