Equity and efficiency of health resource allocation in Sichuan Province, China.

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES BMC Health Services Research Pub Date : 2024-11-20 DOI:10.1186/s12913-024-11946-5
Minghua Zhou
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Abstract

Background: To analyze the equity and efficiency of health resource allocation in Sichuan Province and to provide a scientific basis for promoting health resource development.

Methods: Theil index, coefficient of variation, equalization index and health resource agglomeration degree (HRAD) were used to analyze the equity of health resource allocation, and data envelopment analysis (DEA) was used to analyze the efficiency of health resource allocation in Sichuan Province from 2017 to 2021.

Results: The Theil index and coefficient of variation of health technicians, licensed (assistant) physicians and registered nurses are larger than those of the number of beds, indicating that the equalization of the number of beds is relatively good. The equalization index of health resources in Sichuan Province ranges from 3.228 2 to 3.404 4 between 2017 and 2021, showing a gradually decreasing trend. The equalization index of Northwest Sichuan Economic Zone is the largest, indicating that the equity is relatively good. The equalization index of Chengdu Plain Economic Zone is the lowest, indicating that the equity is relatively poor. The HRAD of the number of beds, health technicians, licensed (assistant) physicians and registered nurses in Chengdu Plain Economic Zone, South Sichuan Economic Zone and Northeast Sichuan Economic Zone are all greater than 1, indicating that the health resources in these regions are better allocated by geography. The HRAD/ population agglomeration degree (PAD) of health technicians, licensed (assistant) physicians and registered nurses in South Sichuan Economic Zone, Northeast Sichuan Economic Zone and Panxi Economic Zone is less than 1, indicating that the health resources in these regions are insufficient relative to the agglomerated population. The comprehensive efficiency of health resource allocation in Sichuan Province and the five economic zones in 2020 is not 1, and the DEA is relatively ineffective. The Panxi Economic Zone, Northeast Sichuan Economic Zone and Northwest Sichuan Economic Zone all have relatively ineffective DEA.

Conclusions: From 2017 to 2021, health resources in Sichuan Province continue to grow, but equity has gotten worse. The degree of variation in the health resource allocation among the five major economic zones in Sichuan Province is large, with the Chengdu Plain Economic Zone having better equity in the health resource allocation by population and geography, and the Panxi Economic Zone and the Northwest Sichuan Economic Zone having insufficient equity in the health resource allocation by population and geography. The efficiency of health resource allocation in the Panxi Economic Zone, Northeast Sichuan Economic Zone and Northwest Sichuan Economic Zone needs to be improved.

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中国四川省卫生资源分配的公平与效率。
研究背景分析四川省卫生资源配置的公平性和效率性,为促进卫生资源开发提供科学依据:采用Theil指数、变异系数、均等化指数和卫生资源集聚度(HRAD)分析四川省2017-2021年卫生资源配置的公平性,采用数据包络分析法(DEA)分析四川省2017-2021年卫生资源配置的效率:卫生技术人员、执业(助理)医师和注册护士的Theil指数和变异系数均大于床位数,说明床位数的均等化程度相对较好。2017-2021 年,四川省卫生资源均等化指数在 3.228 2~3.404 4 之间,呈逐渐下降趋势。川西北经济区的均等化指数最大,说明公平性相对较好。成都平原经济区的均等化指数最低,说明公平性相对较差。成都平原经济区、川南经济区和川东北经济区的床位数、卫生技术人员数、执业(助理)医师数和注册护士数的 HRAD 均大于 1,说明这些地区的卫生资源在地域上得到了较好的配置。川南经济区、川东北经济区和攀西经济区的卫生技术人员、执业(助理)医师和注册护士的HRAD/人口聚集度(PAD)均小于1,说明这些地区的卫生资源相对于聚集人口而言不足。2020 年四川省及五大经济区卫生资源配置综合效率不为 1,DEA 效果相对较差。攀西经济区、川东北经济区、川西北经济区的DEA均相对无效.结论:从 2017 年到 2021 年,四川省卫生资源持续增长,但公平性变差。四川省五大经济区卫生资源配置差异程度较大,成都平原经济区人口和地域卫生资源配置公平性较好,攀西经济区和川西北经济区人口和地域卫生资源配置公平性不足。攀西经济区、川东北经济区和川西北经济区卫生资源配置效率有待提高。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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